Pycnogenol® (Pyc) is an extract from a plant bark known as Pinus pinaster. Some studies have shown that Pyc can prevent oxidative damage, inhibit inflammatory cytokines and be used in the treatment of metabolic syndrome. This study aimed to review the state of the art of Pyc in the treatment of cardiovascular disease. The keywords “pycnogenol” and “cardiopathy” were searched on the PubMed, Scopus, The Cochrane Library, Scielo and Bireme databases. Studies involving animals or with no relation to cardiological conditions were excluded. The findings in the literature point Pycnogenol® as a promising substance in the treatment of cardiovascular conditions, as well as in other medical situations. Some studies have showed benefits in reduction of antihypertensive drugs dose and collateral effects, better control of diabetes, and reduction of cardiovascular risk factors. However, these results were obtained from studies with small sample of patients, limited follow-up and important biases. Further studies such as larger clinical trials are needed to elucidate the real risk-benefit of Pycnogenol® on treatment of cardiovascular diseases.