OBJECTIVES: To identify utilities reported for cardiovascular (CV) events in the literature and evaluate the variability in reported utilities. METHODS: A systematic literature review (SLR) was conducted in Embase, PubMed, and grey literature between 1992 and August 2015 using keywords for utilities and CV events, including stroke, heart failure (HF), and acute coronary syndrome (ACS, including myocardial infarction (MI) and angina). Variability in utilities based on disease severity, time since event, elicitation method, respondent type, and geography was assessed. RESULTS: The SLR included 290 papers. Reported utilities for CV events varied substantially (ranges, stroke: -1.99–0.99; HF: 0.199–0.995; ACS: 0.11–1), potentially driven by the variety in health states measured. More severe disease was associated with lower utility values for stroke (mild: 0.55–0.961; severe: -1.57–0.7), HF (mild: 0.56–0.99; severe: 0.235–0.675), and angina (mild: 0.76–0.983; severe: 0.54– 0.944). Within studies, utilities were sensitive to time since event for MI, but not stroke or HF. Additionally, approaches to utility elicitation impacted values: in all CV conditions assessed, the EQ-5D yielded low utility estimates more often than other methods; the SF-6D resulted in very narrow ranges of estimates (0.55–0.88). Utility values derived from general population respondents were similar to those derived from patients for stroke and HF; however, ACS patients reported lower values (0.05–1.00) than general population respondents (0.45–0.82). Furthermore, in the UK, EQ-5D values for stroke (lowest quarter: -0.14–0.46) were more often lower than those in the US (0.1–0.66), or those in the UK elicited by other methods (0.19–0.55), potentially due to differences in the tariff algorithms used to calculate the EQ-5D index score. CONCLUSIONS: Utility values for CV events vary widely and should be selected with attention to disease severity, time since event, and elicitation method.