Background <p>Municipal solid waste incinerators (MSWIs) are known sources of air pollutants, particularly PM_2.5, which have been implicated in adverse human health effects. However, the association between living near MSWIs and the development of cardiovascular diseases (CVDs) remains inconclusive. This study aimed to investigate the occurrence of CVDs among residents living near MSWIs with varying waste treatment capacities (WTC).</p> Methods <p>This study utilized data from the Taiwan Biobank, a large-scale population-based cohort, collected between 2008 and 2018. The initial dataset comprised 105,371 adult participants. From this, a final analytic cohort of 2516 participants was selected, matched by age and gender to control for potential confounding variables. Participants were categorized into two groups based on their proximity to MSWIs with high WTC (G1) or low WTC (G2). Data on systolic blood pressure (SBP), diastolic blood pressure (DBP), blood glucose, glycated hemoglobin (HbA1c%), and blood lipid profiles were extracted from the database. The Framingham risk score (FRS) was calculated to estimate participants’ 10-year risk of developing CVDs. Additionally, PM_2.5 concentrations near the two groups were compared.</p> Results <p>The results indicated a significantly higher PM_2.5 concentration in the G1 group compared to the G2 group. Residents living near high WTC MSWIs exhibited significantly higher SBP and DBP compared to those living near low WTC MSWIs. Furthermore, the 10-year FRS, indicating the risk of developing CVDs, was significantly higher in the G1 group. For each unit increase in PM_2.5 level, SBP, DBP, and FRS increased by 0.60&#xa0;mmHg, 0.26&#xa0;mmHg, and 0.06, respectively.</p> Conclusion <p>Given the potential cardiovascular health risks linked to PM_2.5 emitted from MSWIs, the findings strongly suggest the necessity of implementing stricter regulations and mitigation strategies to reduce emissions and ensure public health protection.</p> Graphical abstract <p></p>