AIMS: Insulin resistance is a major risk factor for cardiovascular disease. Thus, early identification of insulin resistance is important for classifying individuals at high cardiovascular risk. All the tools commonly used in epidemiological studies and clinical practice to assess insulin resistance require measuring insulin levels, which is a limitation. Hence, simpler methods have been proposed to overcome these limitations. One of the most promising is the triglyceride-glucose index. Therefore, this narrative review focuses on the most significant epidemiological findings concerning the relationship between the triglyceride-glucose index and cardiovascular risk. Furthermore, it also highlights this new tool's strengths, limitations, and perspectives for assessing cardiovascular risk. DATA SYNTHESIS: Even though the assessment of this index is relatively recent, there are numerous papers on this topic, and their number is constantly increasing. Observational studies have shown a substantial positive association between the triglyceride-glucose index and cardiovascular risk, although some conflicting results have been observed. CONCLUSIONS: The index is strongly associated with cardiovascular mortality and cardiovascular risk factors. However, some gaps need to be addressed.