Chronic obstructive pulmonary disease (COPD) is highly prevalent worldwide. Its morbidity and mortality are increasing and it is predicted to be the third leading cause of death by 2020. COPD and cardiovascular disease (CVD) are chronic conditions that share many risk factors and a complex pathophysiology. Current literature has closely focused on the relationship between these two diseases and today COPD is considered to be an independent risk factor for CVD, which is the leading cause of death in approximately 50% of COPD patients. Coronary artery disease, congestive heart failure, pulmonary hypertension, cardiac arrhythmias, peripheral artery and cerebrovascular disease have been documented to present more frequently in COPD patients than in individuals without COPD. Moreover, despite the fact that the exact pathophysiologic mechanism linking COPD to CVD is not yet found, systemic inflammation is one of the most likely protagonists of this connection, as atherosclerosis is directly associated with inflammation. Finally, the aim of this review is to assess the prevalence of cardiovascular comorbidities on COPD patients, to detect the possible pathophysiological mechanisms and to discuss the available therapeutic options aimed at managing these comorbidities and reducing the COPD associated cardiovascular risk.