Cardiovascular morbidity and mortality are increased in immune-mediated inflammatory diseases (IMIDs). Among other factors, chronic inflammation appears to be a cornerstone in the development of cardiovascular disease. The usual risk stratification tools tend to underestimate risk in patients with inflammatory diseases. Treatments used for IMIDs have an impact on how vascular disease presents. Through a narrative review of the literature, we summarize strategies for the detection of subclinical cardiovascular disease (atherosclerosis) and individual risk stratification. We also review the presentation of cardiovascular disease in each of the IMIDs. Finally, we present strategies for the management of cardiovascular risk in these patients.