Environmental pollution is a significant modifiable risk factor for cardiovascular disease (CVD). A growing body of evidence links environmental pollution to adverse CVD outcomes, making it a leading risk factor for early mortality. Pollution is a global health challenge that requires a multifaceted approach to mitigate, including social, economic, legislative, and engineering solutions, as well as lifestyle practices. Major guidelines for preventing CVD have focused on modifiable risk factors, but environmental pollution has not been adequately highlighted. This review discusses major environmental pollutants and their effects on CVD, highlighting pathophysiological mechanisms and strategies to reduce CVD risk. Soil and water pollution, caused by agriculture, industry, and waste disposal, can harm aquatic life, reduce crop yields, and impact human health. Common pollutants include heavy metals, pesticides, plastic waste, and persistent organic pollutants (POPs). Plastics, due to their long degradation times, release toxic compounds like POPs and chemical additives. Phthalates and bisphenol A (BPA) are associated with increased CVD risk, including coronary artery disease (CAD) and heart failure (HF). Pesticides, such as TCDD, are linked to increased CVD risk, while PCBs are associated with increased CVD mortality. Metallic pollutants, including arsenic, cadmium, lead, copper, and mercury, are linked to CVD through mechanisms such as oxidative stress and systemic inflammation. Light pollution disrupts circadian rhythms and increases CVD risk, while noise pollution, a significant risk factor for CVD, is linked to CAD and MI. Mitigating pollution requires individual, governmental, and societal actions, including reducing plastic production, promoting sustainable practices, and implementing policies to reduce emissions. Pollution contributes to CVD through shared pathophysiological mechanisms, including oxidative stress, systemic inflammation, atherothrombosis, and autonomic dysfunction. Despite significant evidence linking pollution to adverse health outcomes, prevention and mitigation are not receiving enough attention. There is an urgent need for international public health strategies to curb pollution, including major policy changes, increased public awareness, and innovation. Governments, health agencies, and cardiology providers should prioritize research and implementation strategies to better understand and address the CV effects of pollution. Clinicians must advocate for pollution control, raise awareness, and educate patients on avoiding exposure to common pollutants.Environmental pollution is a significant modifiable risk factor for cardiovascular disease (CVD). A growing body of evidence links environmental pollution to adverse CVD outcomes, making it a leading risk factor for early mortality. Pollution is a global health challenge that requires a multifaceted approach to mitigate, including social, economic, legislative, and engineering solutions, as well as lifestyle practices. Major guidelines for preventing CVD have focused on modifiable risk factors, but environmental pollution has not been adequately highlighted. This review discusses major environmental pollutants and their effects on CVD, highlighting pathophysiological mechanisms and strategies to reduce CVD risk. Soil and water pollution, caused by agriculture, industry, and waste disposal, can harm aquatic life, reduce crop yields, and impact human health. Common pollutants include heavy metals, pesticides, plastic waste, and persistent organic pollutants (POPs). Plastics, due to their long degradation times, release toxic compounds like POPs and chemical additives. Phthalates and bisphenol A (BPA) are associated with increased CVD risk, including coronary artery disease (CAD) and heart failure (HF). Pesticides, such as TCDD, are linked to increased CVD risk, while PCBs are associated with increased CVD mortality. Metallic pollutants, including arsenic, cadmium, lead, copper, and mercury, are linked to CVD through mechanisms such as oxidative stress and systemic inflammation. Light pollution disrupts circadian rhythms and increases CVD risk, while noise pollution, a significant risk factor for CVD, is linked to CAD and MI. Mitigating pollution requires individual, governmental, and societal actions, including reducing plastic production, promoting sustainable practices, and implementing policies to reduce emissions. Pollution contributes to CVD through shared pathophysiological mechanisms, including oxidative stress, systemic inflammation, atherothrombosis, and autonomic dysfunction. Despite significant evidence linking pollution to adverse health outcomes, prevention and mitigation are not receiving enough attention. There is an urgent need for international public health strategies to curb pollution, including major policy changes, increased public awareness, and innovation. Governments, health agencies, and cardiology providers should prioritize research and implementation strategies to better understand and address the CV effects of pollution. Clinicians must advocate for pollution control, raise awareness, and educate patients on avoiding exposure to common pollutants.