OBJECTIVES: To review the direct patient-level costs of selected cardiovascular events (CVEs): unstable angina, myocardial infarction (MI), cardiac revascularization, heart failure, ischemic stroke, acute coronary syndrome in Europe.  METHODS: A systematic literature review was conducted for the period between January 2000 and March 2015. MEDLINE, EMBASE, ECONLIT, and NHS Economic Evaluation Database, conference abstracts from the American Heart Association, American College of Cardiology, European Society of Cardiology, European Atherosclerosis Society, International Society of the Pharmacoeconomics and Outcomes Research and relevant reference lists were searched to identify published articles reporting direct costs of one or more CVEs (angina, myocardial infarction, cardiac revascularization, heart failure, ischemic stroke, acute coronary syndrome) in Europe (United Kingdom, Germany, Spain, France, Italy, Denmark, Finland, Iceland, Norway, Sweden, Belgium, Switzerland, The Netherlands). Two reviewers independently assessed studies against inclusion criteria and abstracted cost estimates; discrepancies were resolved through discussion or by third reviewer. Studies were included if they reported patient-level direct medical costs of one or more CVE(s) from a primary economic analysis or cost-effectiveness model among adults with identified dyslipidemia or elevated Low Density Lipoprotein-Cholesterol. Costs as reported in each study were inflated to 2015 values. RESULTS: Forty-eight studies were included for abstraction. Cost estimates for at least one event were found in twelve of the thirteen specified countries listed in the search strategy. Annual costs of care were highest for stroke (€958-€10,334), revascularization procedures (€211-€12,383) and MI (€558-€17,262). The highest cost acute events were revascularization procedures, specifically CABG (€10,814- €25,587), and ischemic stroke (€3,686-€7,978); angina (€935-€5,214) and heart failure (€1,106-€4,905) acute costs were relatively lower than other conditions.   CONCLUSIONS: The findings of this study highlight the wide variation in the sources and populations used to populate economic models in the literature and the substantial costs of CVEs despite event type or country of origin.