Purpose of Review <p>Cardiovascular disease remains the leading cause of morbidity and mortality globally. Risk calculators help identify individuals at highest risk for atherosclerotic cardiovascular disease (ASCVD) to guide primary prevention strategies. This review describes the process of creating a risk calculator, differences between common cardiovascular risk models, and additional tools available to predict cardiovascular disease risk.</p> Recent Findings <p>Cardiovascular risk calculators use multiple clinical variables to estimate future cardiovascular events. Models differ in included variables, outcome definitions, and generalizability to various populations. The newest model in the United States (US) is PREVENT, which is notable for excluding race and ethnicity, incorporating kidney function and a social deprivation index, and expanding applicability to younger adults.</p> Summary <p>Cardiovascular risk assessment tools have evolved to improve identification of individuals at highest risk for heart disease. Contemporary algorithms incorporate novel risk factors, draw from more diverse validation cohorts, and have shifted from using race and ethnicity to integrating social deprivation indices. Additional risk-enhancing tools, such as biomarkers, comorbidities, computed tomography imaging, polygenic risk scores, and artificial intelligence, offer further refinement in individual risk stratification. Ongoing innovation in these areas promises to enhance predictive accuracy and support more personalized preventive care.</p>