Introduction: Cardiovascular diseases (CVD) are the leading cause of death worldwide. The number of tooth extraction patients with cardiovascular disease in our country is increasing year by year. Blood pressure control, determination of cardiac function, recognition of arrhythmias, glycemic control, and use of antiplatelet agents or oral anticoagulants need to be investigated. Objective: It was to carry out a concise systematic review of the main relationships of tooth extraction in patients with cardiovascular diseases, to emphasize the main risk predictors. Methods: The systematic review rules of the PRISMA Platform were followed. The search was carried out from February to March 2023 in the Scopus, PubMed, Science Direct, Scielo, and Google Scholar databases, using articles from 2009 to 2022. The quality of the studies was based on the GRADE instrument and the risk of bias was analyzed accordingly, according to the Cochrane instrument. Results and Conclusion: A total of 124 articles were found, 38 articles were evaluated and 24 were included and developed in this systematic review study. Considering the Cochrane tool for risk of bias, the overall assessment resulted in 26 studies with a high risk of bias and 40 studies that did not meet GRADE. It was concluded that the cardiovascular response of elderly outpatients with systemic diseases during tooth extraction is quite significant. Age, sex, systemic diseases, and some tooth extractions may be risk factors closely associated with cardiovascular response. It is necessary for the dental treatment of these patients with heart disease a good knowledge of the subject and requires medical and dental coordination. Dental surgeons need to be prepared to identify possible medical and dental emergencies and take steps to prevent or treat them effectively and quickly.