Cardiovascular diseases (CVD) are the leading cause of mortality in men and women both in developed as well as developing countries like India with an estimate of 20 million people dying, mainly from heart disease and stroke each year as per WHO. It is well established that men tend to develop cardiovascular diseases one decade earlier as compared to females. The loss of female sex hormones after menopause contributes to the striking increase in the incidence of cardiovascular morbidity and mortality in menopausal women. The biological explanations for the gender differences underlie the importance of sex hormones. The endogenous sex hormones are testosterone, dehydroepiandrosterone sulfate, estradiol and progesterone. In this article we have discussed sex hormones and their influence on cardiovascular disease risk factors, cardiac risk and vascular function.