Liver transplantation (LT) has achieved excellent short-term outcomes; however, long-term survival remains limited by cardiovascular disease, now a leading cause of late mortality in transplant recipients. Immunosuppressive therapy is a major contributor to this risk through both direct vascular toxicity and indirect metabolic effects. This review examines the clinical impact of immunosuppression-associated vascular remodeling and strategies to reduce cardiovascular complications after LT. Calci