Obesity is an established risk factor for cardiovascular diseases (CVD) such as hypertension (HD), coronary artery disease (CAD), heart failure (HF), arrhythmias and venous thromboembolism. Lifestyle modifications to reduce weight have been shown to be successful in the short term, however their long-term results are still equivocal likely due to modest weight reduction and high recurrence rates. Bariatric surgery has been recognized as the most effective strategy in achieving substantial sustained weight loss, and can prevent the development or reverse CVD, metabolic syndrome, diabetes mellitus, obstructive sleep apnea syndrome, cancer, and COVID-associated complications. Bariatric surgery results in rapid weight loss over several months that lasts for at least 12-18 months. The surgery lowers all-cause mortality risks, risks of myocardial infarction and stroke. Furthermore, bariatric surgery contributes to the reduction of urgent hospitalizations for heart failure, coronary artery disease, and hypertension. The article shows modern view on the impact of bariatric surgery on the pathogenesis of the CVD in patients with obesity, indications and contraindications of the surgery, tactics of management of patients with existing cardiovascular pathology before the bariatric surgery.