Background: Cardiovascular calcification is defined as the deposition of calcium in vascular tissues. It represents a key aspect of cardiovascular disease pathology, and a serious medical problem associated with high morbidity and mortality. Main body: This review studies the intricate mechanisms underlying vascular calcification to elucidate its multifactorial etiology. Furthermore, it examines the contributory roles of traditional cardiovascular risk factors, genetic predispositions, and molecular pathways that influence the beginning and development of calcification in arterial walls. It also investigates emerging strategies for preventing and mitigating vascular calcification. Novel interventions, including pharmacological agents, lifestyle modifications, and targeted therapies, are examined in the context of their potential to counteract the calcification process. Conclusions: The findings hold promise for developing personalized preventive strategies that reduce the burden of cardiovascular disease worldwide.