The Marfan syndrome is an autosomal dominant disorder of the connective tissue with mutations on the fibrillin-1 gene encoding for fibrillin, a major component of the extracellular microfibrils. The prevalence of the syndrome is 7-17/100,000. The mean life expectancy for untreated patients with Marfan syndrome is 32 years with aortic dissection, aortic rupture or cardiac failure due to mitral and aortic valve regurgitation as the predominant cause of death in > 90% of the cases. In severely affected cases with neonatal Marfan syndrome, patients are likely to survive only a few months. According to the literature database the prevalence of aortic dilatation is 76%, 26% for aortic regurgitation, 62% for mitral valve prolapse, and 29% for mitral valve regurgitation in adult patients with classic Marfan syndrome. Pathogenesis and the natural cause of each cardiovascular manifestation is thoroughly discussed with the problems resulting from associated cardiac arrhythmias, sudden cardiac death, endocarditis, and less frequent cardiovascular manifestations of the Marfan syndrome. Special focus is placed on the analysis of cardiovascular complications during pregnancy.