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Globally, cardiovascular disease has consistently been the leading cause of death. Its pathogenesis is complex and involves interactions among multiple factors, with inflammatory mechanisms garnering increasing attention. Pyroptosis-pro-inflammatory programmed cell death-is categorized into classical, non-classical, and other pathways. Among these, the inflammasome-induced classical pathway has been rigorously studied. Recent findings show that pyroptosis is essential for the development and course of cardiovascular conditions, especially atherosclerosis, myocardial infarction, and heart failure. This review analyzes current evidence on the molecular underpinnings and clinical significance of NLRP3-induced pyroptosis in cardiovascular disease. This review addresses a critical gap in current anti-inflammatory therapies for cardiovascular disease by bridging molecular insights with translational innovations. It advocates for mechanism-driven clinical trials and the use of pyroptosis-modulating techniques to develop next-generation therapies, aiming to provide a theoretical framework for subsequent studies and treatment approaches.