OBJECTIVES: There is an established causal link between obesity and cardiovascular outcomes. The aim of this review was to determine whether an independent relationship exists between anthropometric measurements of weight (typically body mass index [BMI]) and cardiovascular outcomes (e.g., angina, myocardial infarction, congestive heart failure, stroke, mortality) in the general population and in patients with type-2 diabetes. METHODS: A review of the medical literature was conducted between 1988 and May 2008 using the PubMed, EMBASE, Cochrane and Center for Review and Dissemination databases. We included studies that were longer than 12 months, had greater than 500 adult subjects and were written in the English language. RESULTS: In studies conducted in general populations there was an overall trend towards increased risk for cardiovascular outcomes with increasing BMI. However, a few studies reported a J-shaped or U-shaped between BMI measurements and cardiovascular events. The nature and strength of this relationship varied according to the measurement used (e.g., BMI, waist circumference, waist-to-hip ratio) and the population studied, with notable differences observed in Asian/Asia-Pacific based studies compared with those conducted in European or North American populations. There was limited data from prospective, long-term, longitudinal studies examining the relationship between degrees of weight and cardiovascular disease in patients with type-2 diabetes. CONCLUSIONS: In general, the degree of being overweight or obese was associated with an elevated risk of adverse cardiovascular events and mortality. Although inextricable links exist between obesity, type-2 diabetes and cardiovascular disease in the general population, the extent to which findings can be extrapolated to a diabetes-specific population is limited.