Cardiovascular system may be the target of multiple occupational risk-factors which can act as causal and co-causal agents. A clinical background of cardiovascular diseases is made difficult by the non-specific anatomic and clinical characteristics and by the simultaneous presence of non-occupational confounding factors. Similarly, a strong distinction between macro- and microangiopathies is not easy because many noxae play a role on both components of the vascular system. Etiologically speaking, cardiovascular diseases can be classified into three different groups: diseases caused by chemical agents, by physical agents, and the ones related to psychosocial and organizational factors. These last factors represent an emerging risk, with related costs for the individual and the society. The assessment of relationships between occupational exposure and cardiovascular diseases allows both to verify the efficacy and the effectiveness of current prevention strategies and to enable the identification of new risk factors.