Lead is a highly toxic metal that remains a public health concern worldwide. Even at historically low blood lead levels, lead exposure results in adverse health effects in adult populations, including mortality. The mode of action of lead in cardiovascular systems involves oxidative stress and calcium-dependent cellular processes. This paper reviews the literature on lead and cardiovascular function, including robust toxicological and epidemiological evidence of the impacts of lead exposure on morbidity and mortality. It also discusses evidence from a recent randomized controlled trial of chelation therapy in a high-risk population that suggests that reducing lead body burden can lead to immediate improvements in cardiovascular health.