It is becoming increasingly evident that the low serum levels of testosterone experienced by aging men are associated with increased all-cause mortality from CHD and other vascular disorders. Achieving a normal physiological testosterone concentration through the administration of testosterone therapy has been shown to provide beneficial effects on the pathophysiological markers and clinical symptoms of CHD. Many of the factors involved in the atherosclerotic process are interlinked with other, increasingly prevalent pathological conditions such as obesity, the metabolic syndrome (MetS), type 2 diabetes and erectile dysfunction, suggesting that testosterone therapy has potentially wide-ranging health benefits. As the number and scope of testosterone substitution and androgen deprivation studies increases and evidence accumulates, it is timely to assess available data and this review summarises the current understanding of the effects of testosterone on cardiovascular risk factors with particular emphasis on the relevance of testosterone treatment.