Chronic and long-term exposure to heavy metals is a significant public health problem today. Development and globalization present challenges to constant control and monitoring, mainly of metals and toxic substances, including arsenic (As). It is estimated that nearly 200 million people worldwide are at serious risk of exposure. The purpose of this review is to summarize the impact of long-term of exposure to As on selected cardiovascular diseases in humans, based on the available literature. This narrative review provides an insight into the complexity of the processes of arsenic’s influence on cardiovascular health and attempts to identify factors that may serve as potential preventive targets. Arsenic exposure has been associated with several cardiovascular outcomes, including hypertension, atherosclerosis, venous insufficiency, stroke, and myocardial infarction. Common exposure to As and other metals is inevitable, but it is worth noting that the difference in its toxicity may be due to gender, diet, exposure, and dose level, among other factors. Even in the case of the smallest and short-lived exposures, the poisonous and immensely damaging effects of As pose a serious risk of at least cardiovascular health, a major public health challenge as global growth continues. The challenge for future epidemiological and public health research on As and vascular diseases should be to study long-term exposure to As at the individual level in different groups. Reliable biomarkers with appropriate references to the sample should be used, individuals with low and moderate exposure should be included, and a modern genomic approach should be used to analyze genetic susceptibility. Med Pr Work Health Saf. 2025;76(6)