The effect of the urban vs. rural environment on cardiovascular health is an extremely significant issue, nowadays. Up to date, there is a number of studies revealing that there is environmental impact on the prevalence of cardiovascular disease (CVD). The aim of the current systematic review was to investigate the relationship between the natural environment and cardiovascular health, through the differences between urban and rural environments. A literature search was conducted during July 2022-November 2022 using the databases PubMed/Medline, Scopus and Google Scholar (limited to the last 10 years). The search identified four studies that fulfilled the main aim of the present review. Regardless of the limited number of studies, it was shown that the different environments have a great impact on cardiovascular health. Specifically, various factors seem to affect the occurrence of CVDs in both urban and rural environments. The present review highlights the effect of urban vs. rural environment in relation to cardiovascular risk factors. However, there is a necessity for further investigation in this field in order to shed more light on the environmental components with the most significant impact.