This systematic review examines the burden of cardiovascular diseases (CVDs) attributed to air pollution, including prevalence, hospitalization, disability, mortality, and costs. The study analyzed 92 eligible studies published up to June 2023, revealing that chronic exposure to air pollutants significantly increases the prevalence, hospitalization, disability, mortality, and costs of CVDs, even at low levels. PM2.5 was closely associated with hypertension, while PM2.5 exposure increased global stroke-related disability-adjusted life years (DALYs) by 1.8 times between 2016 and 2019, and CVD-related hospitalizations increased by 8.5 times between 2014 and 2023. Ambient air pollution is a significant but underestimated contributor to CVD burden and public health costs, and should be considered both an environmental and health risk factor. The findings highlight the need for preventive measures to reduce the impact of CVDs on society. The review also identified limitations in current research, including limited study populations, focus on a single CVD type, and limited pollutant analysis. The study emphasizes the importance of addressing air pollution to mitigate CVD burden and improve public health outcomes.This systematic review examines the burden of cardiovascular diseases (CVDs) attributed to air pollution, including prevalence, hospitalization, disability, mortality, and costs. The study analyzed 92 eligible studies published up to June 2023, revealing that chronic exposure to air pollutants significantly increases the prevalence, hospitalization, disability, mortality, and costs of CVDs, even at low levels. PM2.5 was closely associated with hypertension, while PM2.5 exposure increased global stroke-related disability-adjusted life years (DALYs) by 1.8 times between 2016 and 2019, and CVD-related hospitalizations increased by 8.5 times between 2014 and 2023. Ambient air pollution is a significant but underestimated contributor to CVD burden and public health costs, and should be considered both an environmental and health risk factor. The findings highlight the need for preventive measures to reduce the impact of CVDs on society. The review also identified limitations in current research, including limited study populations, focus on a single CVD type, and limited pollutant analysis. The study emphasizes the importance of addressing air pollution to mitigate CVD burden and improve public health outcomes.