Background <p>Cardiovascular diseases (CVDs) are among the leading causes of death globally, significantly impacting economic and social structures by diminishing quality of life. Lifestyle changes, particularly increasing physical activity, are effective strategies for CVD prevention and risk factor improvement. Water sports like swimming, rowing, and water walking have shown promise in reducing various CVD risk factors. Despite research on these activities, there is a lack of comprehensive reviews summarizing their effects. This study aims to systematically review the impact of water sports, including swimming, rowing, water polo, kayaking, canoeing, and boating, on cardiovascular risk factors.</p> Methods <p>The keywords including Cardiovascular Risk Factor, Heart Disease Risk Factors, Water Sports, and Swimming were searched in PubMed (MEDLINE), Scopus, Embase, and Web of Science until April 5, 2024. After evaluating the data quality, 11 articles examining the relationship between Heart Disease Risk Factors and Water Sports were entered into the study and reviewed.</p> Results <p>Aquatic exercises have different effects on cardiovascular risk factors. A 14-day aquatic exercise program improved heart rate variability in coronary artery disease (CAD) patients. Swimming improved body composition, cardiorespiratory fitness, leptin, and adiponectin levels, and reduced blood pressure, while water walking did not significantly change flow-mediated dilation. Cold-water swimming was linked to improved lipid profiles, especially in women.</p> Conclusion <p>Although each study has limitations, aquatic exercise, such as swimming, diving, and water walking, has shown potential benefits for cardiovascular health, body composition, and physical fitness. However, further research is necessary to understand the extent and mechanisms of these effects comprehensively.</p>