Sarcopenic obesity (SO), defined as the coexistence of excess fat mass and reduced skeletal muscle mass and strength, has emerged as a significant cardiovascular risk factor, particularly in older adults. This review summarizes recent findings on the diagnosis, prevalence, health impacts, and treatment of SO. Growing evidence suggests that SO exacerbates cardiometabolic risk and adverse health outcomes beyond either condition alone, but the heterogeneity in diagnostic criteria and the observational nature of most studies limit the evaluation of a causal relationship. The European Society for Clinical Nutrition and Metabolism and the European Association for the Study of Obesity have proposed a consensus definition to standardize the diagnosis of SO. Adopting uniform diagnostic criteria will enable more accurate characterization of prevalence and cardiometabolic risk. Current management focuses on diet for weight loss coupled with resistance training to mitigate further muscle loss, and emerging pharmacologic therapies have shown promising results. As the global population ages, diagnosing and managing SO will become imperative to alleviate the cardiovascular burden.Sarcopenic obesity (SO), defined as the coexistence of excess fat mass and reduced skeletal muscle mass and strength, has emerged as a significant cardiovascular risk factor, particularly in older adults. This review summarizes recent findings on the diagnosis, prevalence, health impacts, and treatment of SO. Growing evidence suggests that SO exacerbates cardiometabolic risk and adverse health outcomes beyond either condition alone, but the heterogeneity in diagnostic criteria and the observational nature of most studies limit the evaluation of a causal relationship. The European Society for Clinical Nutrition and Metabolism and the European Association for the Study of Obesity have proposed a consensus definition to standardize the diagnosis of SO. Adopting uniform diagnostic criteria will enable more accurate characterization of prevalence and cardiometabolic risk. Current management focuses on diet for weight loss coupled with resistance training to mitigate further muscle loss, and emerging pharmacologic therapies have shown promising results. As the global population ages, diagnosing and managing SO will become imperative to alleviate the cardiovascular burden.