Abstract: Cardiovascular disease (CVD) has emerged as one of the leading global causes of mortality, with their pathological progression closely linked to immune-metabolic dysregulation. Advances in immunometabolomics have unveiled the central role of metabolic reprogramming in cardiovascular injury. The metabolic reprogramming in immune cells critically regulates inflammatory responses, oxidative stress, and vascular remodeling, profoundly contributing to the pathogenesis of atherosclerosis, myocardial ischemia-reperfusion injury, and heart failure. The rapid development of immunometabolomic technologies has brought high-resolution dynamic mapping of metabolic-immune network interactions, driving the precise identification of metabolic targets and metabolites. Consequently, immune-metabolism-targeted intervention strategies exhibit promising therapeutic potential, particularly in modulating inflammatory microenvironment and improving cardiac metabolic homeostasis. Future efforts should integrate clinical translational research to develop personalized metabolic immunotherapies, offering novel directions for CVD prevention and treatment. This review synthesizes recent progress in immunometabolism research related to CVD, highlights advancements in immunometabolomic technologies, and outlines future therapeutic prospects for immune-metabolic interventions in CVD management.