Acute infections have long been noted to be associated with an increased risk of acute myocardial infarction (MI). In recent years, myriad studies have demonstrated that viral respiratory infections and seasonal influenza in particular, confer a significantly increased risk of both myocardial infarction and ischemic stroke (IS). Men, older patients, and patients with prior atherosclerotic vascular disease are especially vulnerable to influenza–associated vascular events, and the risk appears to be greatest on the first and second week following infection. Several intriguing mechanisms have been implicated, including an inflammation–associated prothrombotic state and effects of cytokines on the stability of pre–existing atherosclerotic plaques. The causal association between influenza and vascular events is strongly supported by several studies that clearly show that the incidence of MI and IS was roughly halved in patients vaccinated against influenza. Since vaccine hesitancy remains prevalent and the goals of 70–75% people vaccinated had not been reached, educating patients on the potential of preventing “heart attack and stroke” may help overcome suboptimal influenza vaccine uptake in the population.