Epidemiological studies suggest that higher flavonoid intake from fruits and vegetables is associated with decreased risk for the development of cardiovascular disease. The mechanisms explaining this observation remain unclear, but current evidence suggests that flavonoids may exert their effects through the improvement of cardiovascular risk factors. The present review summarizes data suggesting that flavonoids improve endothelial function. inhibit low-density lipoprotein oxidation, decrease blood pressure and improve dyslipidemia. A large number of studies have reported the impact of consuming flavonoid-rich foods on biomarkers of cardiovascular disease risk in healthy volunteers or at-risk individuals. Most studies have focused on cocoa, soy, and green and black tea. Recent evidence suggests that some polyphenols in their purified form, including resveratrol, berberine and naringenin, have beneficial effects on dyslipidemia in humans and/or animal models. In a mouse model of cardiovascular disease, naringenin treatment, through correction of dyslipidemia, hyperinsulinemia and obesity, attenuated atherosclerosis. Therefore, the beneficial effects of flavonoids on multiple risk factors may explain, in part, the observed beneficial effects of flavonoids on cardiovascular disease.