With a rising prevalence of obesity and associated metabolic risk factors, cardiovascular disease in particular coronary artery disease, is increasingly recognized in patients for liver transplantation. Identification and management of these cardiovascular risk factors may influence post-transplant clinical outcomes. A detailed assessment of patients’ cardiovascular status is therefore crucial in the decision-making of patients for liver transplantation (LT). Patients with coronary artery disease (CAD) requires risk stratification around the perioperative and long-term postoperative periods. Advanced age, male sex, smoking, diabetes mellitus, hypertension, obesity, and non-alcoholic metabolic associated steatotic liver disease (MASLD) cirrhosis significantly increase the risk of CAD. Patients with these high-risk factors should undergo cardiac investigations with higher sensitivity to identify CAD and those with low-risk factors for CAD may undergo cardiac investigations with high specificity. Cirrhotic patients may suffer from conditions directly related to liver disease, such as cirrhotic cardiomyopathy and portopulmonary hypertension, and unrelated to liver disease, such as arrhythmias. Rarely, valvular heart disease may be identified during transplant evaluation. Clinicians managing patients for LT should carefully evaluate cardiovascular risk and treat appropriately prior to the surgery to minimize post-transplant complications. A multidisciplinary approach involving transplant physicians, anesthetists, cardiologists, and transplant surgeons is strongly recommended.