Cardiovascular disease (CVD) accounts for more than17 million deaths per year worldwide. It has been estimatedthat the influence of lifestyle on CVD mortality amounts to13.7% for smoking, 13.2% for poor diet, and 12% for inactivelifestyle. These results deeply impact both the healthystatus of individuals and their skills in working. The impactof CVD on productivity loss accounts for the 24% in totalcosts for CVD management.Mediterranean diet (MedD) can positively impact on naturalhistory of CVD. It is characterized by a relatively highconsumption of inexpensive and genuine food such as cereals,vegetables, legumes, nuts, fish, fresh fruits, and olive oil as theprincipal source of fat, low meat consumption and low-tomoderateconsumption of milk, dairy products, and wine.Its effects on cardiovascular health are related to thesignificant improvements in arterial stiffness. Peripheralartery disease, coronary artery disease, and chronic heartfailure are all positively influenced by the MedD.Furthermore, MedD lowers the risk of sudden cardiac deathdue to arrhythmias.The present narrative review aims to analyze the effects ofMedD on CVD.