In addition to the ugly appearance and enlarged hands and feet, high levels of growth hormone can cause enlargement of other soft tissues, bones, and internal organs in patients with acromegaly. The impact of acromegaly on the cardiovascular system is extremely important, and this type of disease is known as “acromegaly heart disease” and is the leading cause of death in acromegaly patients. The mortality rate of patients with acromegaly is 30% higher than normal, with cardiac lesions accounting for 60% of the total mortality. Hypertrophic heart disease is seen in approximately 20% of patients without hypertension and with a short course, and in 90% of patients with combined hypertension and a long course. The manifestations of acromegaly heart disease are diverse: (1) cardiovascular structural changes such as myocardial thickening, atrial and ventricular enlargement, widening of the inner diameter of large vessels such as the aorta, and heart valve disease; (2) cardiac functional changes such as diastolic dysfunction, arrhythmias, and systolic dysfunction. Patients can eventually develop cardiovascular lesions that can lead to cardiac insufficiency or even heart failure. Recent studies have shown that independent risk factors for cardiovascular system pathology in patients with acromegaly are advanced age, obesity, and long disease duration. Therefore, early identification of the disease, keeping the patient’s age at admission to a younger age range and making the patient’s disease course correspondingly shorter, and instructing the patient to maintain a healthy weight are effective ways to prevent the development of cardiovascular pathology in patients with acromegaly.