Mortality from cardiovascular and oncological diseases has remained at record highs for many years. Clinicians pay attention to the frequent combination of these two pathologies. Naturally, the question arises, what unites seemingly different diseases among themselves? Modern cancer therapy has allowed many people to achieve a cure or a stable remission, but at the same time led to the appearance of cardiac pathology. The relationship between the development of cardiotoxic events after antitumor therapy has been well studied, but undeservedly little time is allocated in real clinical practice to study vasculotoxicity in patients. This approach can be considered as the earliest predictor of damage to the microvasculature as a result of specific therapy. The analysis of groups of anticancer drugs that cause chronic heart failure and damage to the vascular endothelium to the greatest extent was carried out. The main approaches to risk stratification in cardio-oncological patients are considered. The principles used in the prevention and treatment of cardio- and vasculotoxicity have been studied.