Alqahtani S, et al. - Researchers determined the incidence and outcomes of out-of-hospital cardiac arrests (OHCA) precipitated by drug overdose (OD) via this systematic review of observational or interventional studies reporting the incidence or outcomes of adult OHCA precipitated by drug OD between 1990 and 2018. They used random-effects models and summarised pooled incidence rates per 100,000 person-years and survival outcomes. Of 12 eligible studies, 6 were from North America, 4 from Europe and 2 from Asia. The estimated pooled incidence of EMS-treated OHCA was 1.4 cases per 100,000 person-years. For survival to hospital discharge and survival with favourable neurological outcome, the pooled rate was 9% and 6%, respectively. They reported 25% as the pooled rate of return of spontaneous circulation. Overall, a substantial variability was seen in the incidence and survival outcomes of drug OD OHCA across regions. An improvement in the odds of survival to hospital discharge was observed in relation to drug OD OHCA. There is a need for effective strategies to attenuate incidence and improve survival outcomes.