This study examines the association between circulating interleukin-6 (IL-6) levels and cardiovascular (CV) events in a diverse population of apparently healthy adults without baseline cardiovascular disease (CVD). The MESA (Multi-Ethnic Study of Atherosclerosis) cohort, consisting of 6,622 participants from four racial and ethnic groups, was analyzed. IL-6 levels were measured at baseline and divided into three terciles. Participants in the highest IL-6 tercile (tercile 3) had a significantly higher risk of all-cause mortality, CV mortality, non-CV mortality, and heart failure compared to those in the lowest tercile (tercile 1). When tested as a continuous variable, higher IL-6 levels were associated with increased risk of all outcomes. The association between IL-6 levels and CV outcomes was consistent across all racial and ethnic groups. The study found that higher IL-6 levels were associated with worse CV outcomes and increased all-cause mortality in all racial and ethnic groups. These findings suggest that IL-6 may be a useful biomarker for predicting CV risk and could be a target for therapeutic interventions. The study also highlights the importance of considering racial and ethnic differences in the association between IL-6 levels and CV outcomes. The results indicate that IL-6 levels may play a significant role in the development of atherosclerotic CVD and that targeting IL-6 could be a promising approach for reducing CV events. The study has limitations, including the lack of longitudinal data on IL-6 levels and the inability to infer causality due to the observational nature of the study. Despite these limitations, the study provides important insights into the role of IL-6 in CV disease and its potential as a therapeutic target.This study examines the association between circulating interleukin-6 (IL-6) levels and cardiovascular (CV) events in a diverse population of apparently healthy adults without baseline cardiovascular disease (CVD). The MESA (Multi-Ethnic Study of Atherosclerosis) cohort, consisting of 6,622 participants from four racial and ethnic groups, was analyzed. IL-6 levels were measured at baseline and divided into three terciles. Participants in the highest IL-6 tercile (tercile 3) had a significantly higher risk of all-cause mortality, CV mortality, non-CV mortality, and heart failure compared to those in the lowest tercile (tercile 1). When tested as a continuous variable, higher IL-6 levels were associated with increased risk of all outcomes. The association between IL-6 levels and CV outcomes was consistent across all racial and ethnic groups. The study found that higher IL-6 levels were associated with worse CV outcomes and increased all-cause mortality in all racial and ethnic groups. These findings suggest that IL-6 may be a useful biomarker for predicting CV risk and could be a target for therapeutic interventions. The study also highlights the importance of considering racial and ethnic differences in the association between IL-6 levels and CV outcomes. The results indicate that IL-6 levels may play a significant role in the development of atherosclerotic CVD and that targeting IL-6 could be a promising approach for reducing CV events. The study has limitations, including the lack of longitudinal data on IL-6 levels and the inability to infer causality due to the observational nature of the study. Despite these limitations, the study provides important insights into the role of IL-6 in CV disease and its potential as a therapeutic target.