Background:Smoking is considered a crucial predisposing factor for the development of carotid diseases, cardiovascular disease, and peripheral artery disease. Around 10% of Americans have peripheral artery disease that is most likely related to smoking, and smoking is strongly associated with abdominal aortic aneurysms. The most important cause of death among smokers continues to be cardiovascular diseases. Methodology: We conducted this review using a comprehensive search of MEDLINE, PubMed, and EMBASE, January 1985, through February 2017. The following search terms were used: smoking, cardiovascular diseases, abdominal aortic aneurysms, peripheral vascular diseases, tobacco chemicals, smoking effects on blood vessels Aim: In this review, we aim to study the pathophysiology and mechanism of adverse effects caused by cigarette smoking upon the vascular system. Conclusion: Exposure to smoking both directly and indirectly is associated with significant increase in strokes, coronary heart diseases, aneurysms, and peripheral artery diseases. Atherosclerosis is also strongly associated with cigarette smoking. Smoking cessation will rapidly improve the overall health status and decrease the risk of cardiovascular diseases. More studies are needed to evaluate and assess mechanisms associated with smoking-related cardiovascular diseases.