Cardiovascular risk is a clinical factor that represents the probability of developing cardiovascular diseases (CVDs). This risk is shaped by non-modifiable and modifiable factors, including dietary patterns, which are the main lifestyle factor influencing CVD. Dietary polysaccharides, integral to nutrition, have varying effects on cardiovascular health depending on their type and source. They include starches, non-starch polysaccharides, and prebiotic fibers, categorized further into soluble and insoluble fibers. Soluble fibers, found in oats, legumes, and fruits, dissolve in water, forming gels that help lower serum cholesterol and modulate blood glucose levels. Insoluble fibers, present in whole grains and vegetables, aid in bowel regularity. The cardiovascular benefits of polysaccharides are linked to their ability to bind bile acids, reducing cholesterol levels, and the production of short-chain fatty acids by gut microbiota, which have anti-inflammatory properties. However, not all polysaccharides are beneficial; refined starches can lead to adverse metabolic effects, and chitosan to mixed effects on gut microbiota. This review examines the dualistic nature of polysaccharides, highlighting their beneficial roles in reducing cardiovascular risk factors and the potential adverse effects of specific types. Keywords: dietary polysaccharides; fiber; cardiovascular risk; glucan; obesity; metabolic syndrome; cardiovascular prevention; dyslipidemia