This review summarizes the vascular effects of SARS-CoV-2 infection, highlighting its impact on the vascular system beyond the respiratory tract. The virus causes endothelial dysfunction and immune dysregulation, leading to inflammation and a hypercoagulable state, affecting both micro- and macrovasculature. This results in thromboembolic events, cardiovascular issues, impaired arterial stiffness, cerebrovascular complications, and nephropathy, often seen in severe cases. Evidence suggests long-term effects, termed long-term COVID-19, characterized by prolonged inflammation, endotheliopathy, and increased vascular complications. Various imaging techniques, histopathological studies, and diagnostic tools have been used to visualize these changes. The review investigates the pathophysiological mechanisms, clinical manifestations, and therapeutic approaches for SARS-CoV-2-induced vasculopathy. The mechanisms of vascular alterations include endothelial damage, mitochondrial dysfunction, inflammation, clot formation, and immune system involvement. SARS-CoV-2 binds to ACE2 receptors, leading to endothelial injury, inflammation, and coagulation disorders. Mitochondrial damage and the production of reactive oxygen species contribute to endothelial dysfunction and vascular injury. Inflammation is a key feature, with cytokine storms and immune cell activation playing a significant role. Clot formation is promoted by endothelial damage and systemic inflammation, increasing the risk of thromboembolic events. The immune system is also affected, with reduced lymphocyte counts and increased monocytes and macrophages in severe cases. Short-term vascular manifestations include thromboembolic events, pulmonary involvement, cardiovascular alterations, arterial stiffness, cerebrovascular complications, nephropathy, and retinopathy. Long-term effects, such as persistent vascular damage and increased risk of vascular complications, are also discussed. Diagnostic methods include microvasculature imaging, macrovasculature imaging, and other techniques to assess vascular changes. Therapeutic interventions include anticoagulants, anti-inflammatory drugs, and other treatments aimed at mitigating vascular complications. Vaccination is highlighted as a preventive measure. Long-term consequences of SARS-CoV-2 infection include persistent vascular damage, increased risk of vascular complications, and the need for further research to understand and manage these effects. Prevention and future directions emphasize early detection, anticoagulation therapy, and vaccination to reduce adverse outcomes. The review concludes that SARS-CoV-2 has a significant impact on the vascular system, leading to diverse manifestations and complications, and that further research is needed to develop effective treatments and management strategies.This review summarizes the vascular effects of SARS-CoV-2 infection, highlighting its impact on the vascular system beyond the respiratory tract. The virus causes endothelial dysfunction and immune dysregulation, leading to inflammation and a hypercoagulable state, affecting both micro- and macrovasculature. This results in thromboembolic events, cardiovascular issues, impaired arterial stiffness, cerebrovascular complications, and nephropathy, often seen in severe cases. Evidence suggests long-term effects, termed long-term COVID-19, characterized by prolonged inflammation, endotheliopathy, and increased vascular complications. Various imaging techniques, histopathological studies, and diagnostic tools have been used to visualize these changes. The review investigates the pathophysiological mechanisms, clinical manifestations, and therapeutic approaches for SARS-CoV-2-induced vasculopathy. The mechanisms of vascular alterations include endothelial damage, mitochondrial dysfunction, inflammation, clot formation, and immune system involvement. SARS-CoV-2 binds to ACE2 receptors, leading to endothelial injury, inflammation, and coagulation disorders. Mitochondrial damage and the production of reactive oxygen species contribute to endothelial dysfunction and vascular injury. Inflammation is a key feature, with cytokine storms and immune cell activation playing a significant role. Clot formation is promoted by endothelial damage and systemic inflammation, increasing the risk of thromboembolic events. The immune system is also affected, with reduced lymphocyte counts and increased monocytes and macrophages in severe cases. Short-term vascular manifestations include thromboembolic events, pulmonary involvement, cardiovascular alterations, arterial stiffness, cerebrovascular complications, nephropathy, and retinopathy. Long-term effects, such as persistent vascular damage and increased risk of vascular complications, are also discussed. Diagnostic methods include microvasculature imaging, macrovasculature imaging, and other techniques to assess vascular changes. Therapeutic interventions include anticoagulants, anti-inflammatory drugs, and other treatments aimed at mitigating vascular complications. Vaccination is highlighted as a preventive measure. Long-term consequences of SARS-CoV-2 infection include persistent vascular damage, increased risk of vascular complications, and the need for further research to understand and manage these effects. Prevention and future directions emphasize early detection, anticoagulation therapy, and vaccination to reduce adverse outcomes. The review concludes that SARS-CoV-2 has a significant impact on the vascular system, leading to diverse manifestations and complications, and that further research is needed to develop effective treatments and management strategies.