Cardiovascular related diseases are the major cause of death in the United States. The primary goal of the physician should be prevention of these diseases; however, once problems occur, a definitive rehabilitation program must be instituted in addition to the medical and surgical treatment. Although risk factors for the development of cardiovascular disease are numerous, statistical reports suggest that control of these factors might delay or prevent such development. This presentation describes the recommended Physical Medicine and Rehabilitation Program for high-risk patients or those with existing cardiovascular disease. The basis of the physical fitness and rehabilitation program is controlled progression-of-energy-expenditure physical activity and exercise in metabolic equivalents (METS). Education plays a key role in decreasing the incidence of cardiovascular disease, and should start at an early age. Adults at high risk of developing cardiovascular disease should be offered medically supervised physical fitness exercise programs, with monitoring where necessary.