Cardiovascular diseases (CVDs) have become one of the major global health crises of the last century, causing millions of deaths each year, and are the leading cause of disability worldwide. The pharmacological management of these conditions demands new alternative or complementary therapies due to the multiple long-term side effects experienced by patients. In this context, exopolysaccharides (EPSs) have emerged as a promising alternative due to their numerous functional properties and favorable biotechnological and medical applications for health. This review provides an overview of the properties of EPSs as bioactive agents in cardiovascular diseases, highlighting the cellular signaling mechanisms in their role as cardioprotective agents, with a primary focus on their roles as antioxidants, antihypertensives, and cholesterol regulators, and their regenerative effects on vascular epithelia, positioning EPSs as promising biomolecules for CVD prevention.