Cardiovascular disease is a leading cause of death in the United States. Football players represent a subpopulation that may have a unique risk profile pattern. Studies have suggested that football players may be at increased risk for cardiovascular disease. Paradoxically, there may be a cardioprotective effect associated with activity in general and, specifically, participation at higher levels of football. Our review will attempt to outline the pertinent evidence in regards to cardiovascular risk factors in football players. Specifically, hypertension, hypercholesterolemia, obesity, and sedentary lifestyle will be considered. In addition, we will discuss potential risk factors for investigation including C-reactive protein, homocysteine, insulin resistance, and sleep-disordered breathing. Studies at all levels of competition will be considered, including retired players whose findings may represent lifelong changes that occur as a result of participation in football. Further investigation will be needed to help clarify the relationship between football participation and cardiovascular risk.