PURPOSE OF REVIEW: To explore the role of optimal cardiovascular health as defined by the Life's Essential 8 in breast cancer survivors. RECENT FINDINGS: Optimal cardiovascular health may be associated with decreased cancer mortality. Breast cancer survivors may derive additional benefit from obtaining ideal cardiovascular health as defined by the Life's Essential 8. Certain components of the Life's Essential 8 may impact cardiovascular risk but also cancer mortality, and risk for cancer therapy related cardiac dysfunction. Continued physical activity, avoidance of smoking, and control of lipids and blood pressure are beneficial in breast cancer survivors. More study is needed to define the role of anti-hyperglycemic agents, BMI, and sleep on CVD risk in breast cancer survivors. The Life's Essential 8 can be a tool to inform clinicians regarding a breast cancer survivor's disease risk and to identify potential areas of improvement.