To evaluate the effect of cardiovascular disease risk on local recurrence, distant metastasis development and cancer-specific survival in patients with localized (stage 1 and 2) renal cell carcinoma (RCC). Materials and Methods: Data of patients who underwent partial or radical nephrectomy due to pathological stage 1 and 2 RCC between September 2009 and July 2016 were retrospectively evaluated. Ninety-six patients with fully accessible data were included in the study. Demographic data, histological tumor type, Fuhrman grading, local recurrence, metastasis and survival after nephrectomy were recorded. Framingham risk score, which predicts cardiovascular disease within 10 years, was calculated in all patients. The patients were divided into three groups as low (group 1), moderate (group 2) and high risk (group 3). Results: Mean age of patients was 58.66±10.55 years at the time of nephrectomy. Nine (9.4%) patients had local recurrence, 12 (12.5%) had distant metastasis and 11 (11.5%) died due to cancer during a median follow-up period of 57 (6-102) months. Regarding intergroup comparison, local recurrence rate (21.9%, p=0.012) and distant metastasis rate (25%, p=0.025) were significantly higher in group 3, and predicted recurrence-free survival (66.4 months, p=0.005), metastasis-free survival (77 months, p=0.017) and cancer-specific survival (79.9 months, p=0.024) were found to be significantly lower. In univariate analysis, body mass index, total cholesterol level, estimated glomerular filtration rate and Framingham risk score were independent predictive factors for local recurrence, distant metastasis development and cancer-specific survival. In multivariate analysis, body mass index, estimated glomerular filtration rate and Framingham risk score were more significant. Conclusion: Patients who are at high risk of developing cardiovascular disease have more local recurrence, distant metastasis and cancer-specific mortality rates, even though nephrectomy is performed due to localized RCC. Therefore, we suggest that these patients should be followed more carefully in the post-nephrectomy period.