Introduction Cardiovascular disease (CVD) is a major disease that seriously endangers human health. CVD in many adults begins in adolescence and even in childhood. The cardiovascular health of college students in China cannot be ignored. Objective Verify the impacts of aerobic exercise (APA) on the cardiovascular health of college students. Methods The paper uses the literature method to explore the health-promoting role of aerobic exercise in opposing and improving CVD. Also the APA exercise method of effectively improving cardiopulmonary fitness (CRF) to prevent and improve CVD. The results showed that APA can improve microcirculation by increasing microvascular reactivity. Results Coronary blood flow in healthy adults is only 8% to 9% of cardiac bleeding, while coronary blood flow increases by 40% and oxygen intake by 2-2.5 times. Aerobic exercise can improve insulin sensitivity and reduce the risk of CVD. Some risk factors related to vascular endothelial dysfunction, such as hypertension, atherosclerosis, and coronary artery disease, are often accompanied by the phenomenon of insulin resistance in the induction of CVD. At the same time, improving IR may play an effective role in preventing and treating CVD. Conclusion APA can reduce and suppress the occurrence and development of CVD risk factors such as atherosclerosis, hypertension, hyperlipidemia, hyperglycemia and obesity, intestinal microecological disorder, and reduce free radical oxidative damage and apoptosis by improving insulin sensitivity of vascular endothelial cells, inhibiting inflammatory reaction, improving mitochondrial function of cardiomyocytes, reducing body mass index and obesity, and maintaining gut micro-ecological balance, and improving vascular endothelial function and reducing CVD such as myocardial infarction. Level of evidence II; Therapeutic studies - investigating treatment outcomes.