BACKGROUND: Cardiovascular diseases (CVD) are the leading cause of death globally, with a significant burden on the Asian and Central Asian populations. Ethnic discrimination is an emerging determinant of CVD risk, yet comprehensive analyses in these populations are sparse. OBJECTIVES: This systematic review aimed to assess the association between ethnic discrimination and CVD among Asian and Central Asian populations, quantifying risks and examining contributing factors. METHODS: Following the PRISMA guidelines, we reviewed 23 studies across PubMed, Scopus, and the Web of Science, including 10 on Central Asian and 13 on broader Asian populations. Risk measures such as odds ratios (ORs) and hazard ratios (HRs) were extracted where available. RESULTS: The findings indicate a robust association between ethnic discrimination and increased CVD risks. Among Kyrgyz and Kazakh populations, discrimination was linked to hypertension with an OR of 2.4, while ethnic Kazakhs experiencing discrimination had a 70% higher risk of all-cause mortality (HR 1.7). In South Asians, discrimination was associated with a 30% higher prevalence of premature cardiovascular events, while Chinese populations exposed to everyday discrimination demonstrated a 15.2% higher prevalence of hypertension. Rural populations in Central Asia showed clustering of CVD risk factors with an OR of 1.9. CONCLUSIONS: Discrimination is a significant contributor to CVD disparities, with its effects varying across ethnic groups and regions. These findings underscore the need for culturally tailored public health interventions and policies addressing social determinants of health. Future research should explore longitudinal impacts and the efficacy of targeted community-based programs to mitigate these risks.