The increase in pesticide consumption has a negative health impact. Studies point to an association between exposure to pesticides and cardiovascular disease (CVD), one of the leading causes of world mortality. This review synthesize evidence on the association between occupational exposure and environmental contamination by pesticides with CVDs from 1750 references databases (EBSCO, Medline, Science Direct, Scielo, Lilacs and Ovid) without date or language restriction. Selected 24 articles by PRISMA and Downs & Black methodologies, were included from inclusion criteria: original studies (case-control, cohort or cross-sectional design); clear CVD definition and exposure to pesticides; representative sample of the target population. The results show the occupational exposure to pesticides chlorpyrifos, coumafos, carbofuran, ethylene bromide, mancozeb, ziram, metalaxyl, pendimethalin and trifluralin was associated a risk of 1.8 to 3.2 for acute myocardial infarction. Primaphos, fenitrothion, malathion and deltamethrin pesticides were associated with a blood pressure increase. Environmental contamination by tetrachlorodibenzo-p-dioxin was associated with CVD with risk of 1.09 to 2.78 and organochlorine, 1.19 to 4.54; heavy metals, arsenic, trimethylarsine and dimethylarsinic acid with atherosclerosis and systemic arterial hypertension. These findings point to the association between exposure to pesticides and CVD, signaling the importance of greater rigor in the public policy related to pesticides.