WHAT IS ALREADY KNOWN ABOUT THIS TOPIC?: Cardiovascular disease (CVD) represents a major cause of mortality and disability in China's population. Ambient particulate matter pollution (APMP) has been established as a significant risk factor contributing to CVD development. WHAT IS ADDED BY THIS REPORT?: Analysis of data from 1990 to 2021 reveals a substantial increase in APMP-attributable CVD mortality across China. While recent trends show decreased mortality risk associated with APMP-attributable CVD, birth cohort analysis demonstrates continued risk elevation in males but declining risk in females born after 1971. WHAT ARE THE IMPLICATIONS FOR PUBLIC HEALTH PRACTICE?: Enhanced surveillance and regulation of APMP, coupled with targeted health promotion strategies, are crucial, particularly for elderly populations and males who show increased vulnerability.