The Avon Longitudinal Study of Parents and Children (also known as ALSPAC and/or the Children of the 90s Study) is a regional prospective pregnancy cohort involving three generations of families now followed for over 30 years. Originally established in the early 1990s to study modifiable factors influencing childhood development, ALSPAC has since grown into one of the world’s foremost longitudinal studies assessing early-life cardiovascular health. Alongside a wealth of prenatal, genetic, epigenetic, biological, social, psychological, and environmental data, a key strength of ALSPAC has been the inclusion of detailed noninvasive phenotyping of cardiovascular structure and function. This has been carried out repeatedly since the age of ~10 years, allowing the early evolution of cardiovascular disease to be studied at a level of detail not seen elsewhere at this age. Moving forward, these data—combined with stored biosamples, linkage to primary and secondary electronic health records, and continued follow-up of the cohort—will provide new opportunities to investigate how early risk factor profiles and subclinical phenotypes link to clinical events as participants enter middle age and beyond. In this chapter, we will first provide a brief overview of the data available to researchers who may be interested in using ALSPAC to study primordial prevention of cardiovascular disease. We will next summarize some of the key cardiovascular findings gleaned from the cohort over its first three decades of follow-up. Finally, we will discuss ongoing and future opportunities that are expected to arise from continued follow-up of this cohort.