Pesticides are used to protect crops from various pests and against the vectors of life threathening communicable diseases. They are classified into various groups based on their chemical structures, such as organochlorine compounds, organophosphosphates, carbamates, pyrethroids, coumarin derivatives, dipyridyles, triazoles, triazines, etc. These chemicals have intrinsic toxicity, so the impact of pesticide exposure on human health and the environment remains a significant concern. Pesticides’ toxicological profiles include a broad spectrum of possible adverse outcomes such as neurotoxicity, hepatotoxicity, cardiotoxicity, immunotoxicity, endocrine disruption, carcinogenicity, etc. Cardiotoxicity is of particular importance since cardiovascular diseases (CVDs) are among the most significant causes of mortality in humans, e.g. among the top 10 global causes of death in 2021, ischaemic heart disease held the first place. Concerning environmental risk factors, almost all pesticides can induce cardiotoxicity linked to a variety of molecular pathways including an imbalance in Ca2+ homeostasis, mitochondrial dysfunction, and mechanisms such as oxidative stress and apoptosis. Pesticide cardiotoxicity covers different clinical features such as electrocardiogram abnormalities, higher incidences of myocardial infarction, impaired systolic and diastolic performance, increased levels of coronary heart disease markers, and blood pressure disorders. Concerning the cardiovascular risk associated with pesticide exposure, the utmost goal is to build capacity in sound pesticide management across both agriculture and public health sectors following the principles of One Health.