Background <p>This systematic review and meta-analysis aimed to evaluate the association between endometriosis and the risk of cardiovascular disease (CVD).</p> Methods <p>A comprehensive literature search was conducted in PubMed (Medline), Scopus, Web of Science, and Embase, covering studies published from January 2000 to April 2023. Cohort and case-control studies investigating the relationship between endometriosis and CVD risk were included. Random-effects or fixed-effects models were used depending on the heterogeneity among studies. Pooled relative risks (RR) with 95% confidence intervals (CIs) were calculated. Study quality was assessed using an appropriate tool, and statistical heterogeneity was evaluated using the I² statistic. The review was conducted following PRISMA 2020 guidelines.</p> Results <p>Six studies were included in the meta-analysis. Women with endometriosis had a 23% higher risk of developing CVD (RR = 1.23; 95% CI: 1.16–1.31) compared to those without endometriosis. Additionally, the risk of hypertension was 13% higher among women with endometriosis (RR = 1.13; 95% CI: 1.10–1.16). Moderate heterogeneity was observed across studies, and a random-effects model was applied.</p> Conclusion <p>This meta-analysis highlights an increased risk of CVD and hypertension among women with endometriosis. These findings underscore the importance of cardiovascular monitoring and preventive strategies in this population.</p> Trial registration <p>PROSPERO (ID: CRD42023398887).</p>