Cardiovascular diseases (CVD) are the leading cause of death worldwide and along with traditional risk factors, environmental toxicants should be considered as important risk factors for CVD. However, the contribution of pesticide to CVD is still uncertain. In this systematic review we evaluated the evidence on the association between pesticide exposure and CVD in humans. We conducted a comprehensive methods search using Medline (PubMed), ProQuest, EBSCOhost Medical, Scopus and Google Scholar in October 2014. All studies included were epidemiology studies in humans focused on cardiovascular health effects that were published between 2004 and 2014. We had reviewed 26 papers on cardiovascular diseases with pesticide exposure which most studies documented mixed pesticide exposures but the majority of studies examined the health effects of organophosphate. Eight studies examined the long-term effects of chronic low dose exposure to pesticide while the rest were acute poisoning. Overall, there was little evidence of increased risk of myocardial infarction (MI) and MI mortality but individual pesticide evaluation revealed significantly associated with non-fatal MI. Organochlorine is significantly associated with peripheral arterial disease and stroke. In severe poisonings, general impression is that cardiac abnormalities are common. This systematic review suggests that pesticide exposure is associated with increased risk of CVD and CVD mortality. We hope our results will stimulate further evaluation of CVD incidence and mortality in pesticide-exposed cohorts.