Extreme weather events and climate change have witnessed a substantial increase in recent years, leading to heightened concerns. The rise in abnormal ambient temperatures, both in intensity and frequency, directly and indirectly impacts cardiovascular health. While the impact of high ambient temperatures on cardiovascular response is a common concern in the context of global warming, the significance of low temperatures cannot be overlooked. The challenges posed by low temperatures contribute to increased cardiovascular morbidity and mortality, posing a significant threat to global public health. This review aims to provide an overview of the relationship between low ambient temperature and cardiovascular health, encompassing the burden of cardiovascular outcomes and underlying mechanisms. Additionally, the review explores strategies for cold adaptation and cardioprotection. We posit that to optimize cold adaptation strategies, future research should delve deeper into the underlying mechanisms of cardiovascular health in response to low ambient temperature exposure.