Drug-induced cardiovascular toxicity represents a significant clinical challenge, especially in the context of Inflammatory Bowel Disease (IBD) therapies, where medications essential for controlling inflammation can, paradoxically, compromise cardiovascular health. Despite rigorous and extensive preclinical and clinical trials, cardiotoxic effects may still manifest in larger, diverse patient populations, leading to severe complications such as myocarditis, cardiomyopathy, arrhythmias, myocardial ischemia, heart failure, and other conditions. This chapter provides a comprehensive analysis of the cardiovascular risks associated with commonly used anti-IBD therapies, including aminosalicylates, corticosteroids, immunomodulators, and biologics. These drugs, essential for managing chronic inflammation in IBD, may not only exacerbate pre-existing cardiovascular conditions but also induce new cardiac complications. Mechanisms of drug-induced cardiotoxicity often involve oxidative stress, free radical generation, and inflammatory pathways, which compromise myocardial contractility and tissue integrity, increasing both morbidity and mortality. A deeper understanding of such adverse effects allows clinicians to personalize treatment approaches, balancing the therapeutic benefits of IBD management with ensuring cardiovascular safety. Furthermore, this review emphasizes the critical importance of ongoing monitoring and vigilance in clinical practice, as early detection and intervention can significantly mitigate cardiotoxic risks, thereby enhancing the overall quality of care for patients with IBD.