Introduction and Aim Air pollution is a major public health concern, adversely affecting both the respiratory and cardiovascular systems. The main pollutants include particulate matter (PM2.5, PM10), nitrogen oxides (NO2), tropospheric ozone (O3), carbon monoxide (CO), sulfur dioxide (SO2), and other toxic compounds. Numerous studies confirm an association between exposure to these pollutants and increased incidence of cardiovascular diseases, including ischemic heart disease, stroke, arrhythmias, and heart failure. This paper aims to summarise current knowledge on the effects of air pollution on the cardiovascular system and to discuss underlying pathophysiological mechanisms. State of Knowledge Air pollution is one of the leading environmental risk factors for premature mortality worldwide. The most harmful components include fine particulate matter (PM2.5), nitrogen oxides (NO2), ozone (O3), carbon monoxide (CO), and sulfur dioxide (SO₂). In 2021, the World Health Organisation (WHO) revised its air quality guidelines, lowering the recommended annual PM2.5 limit to 5 µg/m3. Pollutants induce oxidative stress, inflammation, endothelial dysfunction, and autonomic imbalance, contributing to cardiovascular disease development and progression. Short-term exposure increases the risk of acute events such as myocardial infarction and arrhythmias, while long-term exposure promotes atherosclerosis and chronic heart failure. The elderly, children, and individuals with chronic diseases are particularly vulnerable. This issue remains a major public health challenge globally. Summary Air pollution is a key risk factor for cardiovascular disease. Reducing exposure through continuous air quality monitoring and effective preventive measures is essential for protecting public health.