Cardiovascular diseases (CVDs) continue to be a leading cause of mortality worldwide, with dietary habits playing a crucial role in CVD prevention. While current guidelines recommend reducing red meat consumption, findings from large-scale observational studies and clinical trials on the impact of red meat intake on CVD risk factors remain inconsistent. The reliance on self-reported dietary intake in observational studies and adherence to intervention in clinical trials might have contributed to inconsistencies. Recent advancements in metabolomics and microbiome research have shed light on the molecular mechanisms through which different types of meat intake may influence cardiovascular health. Meat-derived metabolites, such as trimethylamine N-oxide (TMAO) and branched-chain amino acids (BCAAs), have been implicated in CVD pathogenesis, with the gut microbiota further modulating these effects. In this narrative review we examined the relationship between meat intake, metabolomic profiles, the gut microbiome, and the influence of these variables on CVD risk. Articles published up to June 11, 2025, including reports of both observational and interventional studies, were comprehensively searched in the PubMed and ScienceDirect databases. A total of 74 relevant articles were selected for in-depth analysis. Overall, these studies suggested that red meat intake is linked to higher levels of TMAO, which is associated with increased CVD risk, and that diets rich in red and processed meats were generally associated with reduced gut microbiome diversity more than that found with chicken consumption. Furthermore, the findings of this review highlight the need for future research involving larger sample sizes, multi-omics approaches, and mediation analyses, alongside short-term randomized clinical trials, to elucidate the precise role of meat consumption in CVD risk.