Objective: This systematic review aimed to identify clinical characteristics and predictors of mortality in cardiogenic shock (CS) patients, emphasizing demographic, metabolic, and hemodynamic factors, and to evaluate the prognostic value of dynamic markers and risk scores. Methods: This review followed PRISMA guidelines. PubMed, Scopus, and Web of Science were searched from 2021 through 2025. Eligible studies included adults with CS admitted to intensive care units (ICUs), reported predictors of in-hospital or 30-day mortality, and used observational, registry, or randomized trial designs. Study quality was assessed using QUIPS for prognostic studies and PROBAST for prediction models. Results: Ten studies were included: multicenter registries, trial sub-analyses, and single-center cohorts from Asia, Europe, Africa, and South America. Reported mortality ranged from 34% to 62%. Predictors of poor outcomes included advanced age, cardiac arrest, renal dysfunction, vasopressor requirement, mechanical ventilation, and failed reperfusion in STEMI-related CS. Metabolic markers—particularly hyperglycemia and lactate clearance— showed strong prognostic value, with dynamic measures outperforming static values. Novel risk models— including the PRECISE, BOS, and MA₂ scores—demonstrated promising discrimination for mortality prediction. Conclusion: Mortality in CS remains high and is influenced by demographic, metabolic, hemodynamic, and multi-organ failure indices. Early recognition of prognostic markers, integration of dynamic lactate monitoring, and use of validated risk scores may enhance individualized care and improve outcomes in critically ill CS patients.