BACKGROUND: Cardiac metastatic tumors (CMTs) are rare yet pose significant medical concerns. Clinical studies on CMT are limited, particularly those involving multicenter data analysis. AIM: To systematically analyze the etiology, sources, classification, treatment, and prognosis of CMT. METHODS: A total of 226 CMT patients from two centers (2013 to 2023) were reviewed, and 153 tumor patients from China Health and Retirement Longitudinal Study were used as controls. The survival rates of 96 CMT patients were tracked through medical records and telephone follow-ups. Logistic regression and survival analyses were conducted to characterize CMT. RESULTS: CMTs were predominantly male (67.26% CONCLUSION: Clinicians should consider CMT in the male lung or liver cancer patients with cardiac symptoms. Abnormal coagulation, impaired heart function, tumor location, and age are key prognostic factors for CMT. Surgical intervention is the preferred treatment option, as it significantly prolongs median survival.