Androgen deprivation therapy (ADT) is the standard treatment for metastatic prostate cancer. It has increasingly been used in other stages of the disease as well. Besides well-known side effects caused by the lack of testosterone (impotency, osteoporosis, fatigue, loss of muscle mass), an increase of cardiovascular (CV) morbidity and mortality has recently been discussed in association with ADT. Cardiovascular side effects cannot be sufficiently explained by low testosterone levels. This review gives an overview of the recent literature, interprets the results, and offers clinical consequences.