Background: Hypothyroidism is a common endocrine disorder characterized by deficient thyroid hormone production. The cardiovascular system is particularly sensitive to changes in thyroid hormone levels, and hypothyroidism can lead to a variety of cardiac manifestations. These can range from subtle changes in heart function to severe and life-threatening conditions. Objective: This review aims to summarize the current understanding of the cardiac manifestations associated with hypothyroidism, including their pathophysiology, clinical presentation, and management strategies. Methods: A comprehensive literature review was conducted using databases such as PubMed, MEDLINE, and Google Scholar. Studies and reviews published over the last 20 years were analyzed to provide a detailed overview of the cardiac effects of hypothyroidism. Results: Hypothyroidism can lead to various cardiac manifestations, including bradycardia, increased systemic vascular resistance, reduced cardiac output, and pericardial effusion. Severe hypothyroidism, or myxedema, can precipitate heart failure and exacerbate coronary artery disease. Conclusion: The cardiovascular effects of hypothyroidism are significant and can have serious consequences if not recognized and treated promptly. Regular screening for thyroid function in patients with unexplained cardiac symptoms is crucial for early diagnosis and intervention.