The impact of collaborative and multidisciplinary health care on the outcomes of care in patients with acute coronary syndromes (ACS) is well-established in the literature. However, there is lack of high quality evidence on the role of pharmacist care in this setting. This systematic review aimed to evaluate the impact of pharmacist care on patient outcomes in patients with ACS at or post-discharge. The following databases were searched from their inception to September 2016: PubMed, EMBASE, Cochrane Central Register of Controlled Trials, ISI Web of Science, Scopus, Campbell Library, Database of Abstracts of Reviews of Effects (DARE), Health System Evidence, Global Health Database, Joanna Briggs Institute Evidence-Based Practice Database, Academic Search Complete, ProQuest, and PROSPERO, and Google Scholar. Studies were included if they evaluated the impact of pharmacist’s care (compared with no pharmacist’s care or usual care) on the outcomes of readmissions, hospitalization, emergency visits, mortality, and medication adherence in patients post-ACS discharge. A total of 17 studies [13 randomized controlled trials (RCTs) and four non-randomized clinical studies] involving 8,391 patients were included. The studies were of variable quality (poor to good quality) or risk of bias (moderate to critical risk). Nature and intensity of pharmacist interventions varied among the studies including medication reconciliation, medication therapy management, discharge medication counseling, motivational interviewing, and post-discharge face-to-face or telephone follow-up. Pharmacist-delivered interventions significantly improved medication adherence in four out of 12 studies. However, these did not translate to significant improvements in the rates of readmissions, hospitalizations, emergency visits, and mortality among ACS patients. Pharmacist care of patients discharged after ACS admission was not associated with significant improvement in medication adherence or reductions in readmissions, emergency visits, and mortality. Future studies should use well-designed RCTs to assess the short- and long-terms effects of pharmacist interventions in ACS patients.