Objectives: This study systematically reviewed the peer-reviewed literature to establish morbidity and mortality from myocardial infarction (MI) and stroke among immigrant populations. Methods: The review considered only studies published between 1986 and 2008 that provided data on MI or stroke morbidity/mortality among first-generation immigrants. A prespecified search strategy identified 58 studies for possible inclusion. Of these, 12 met the inclusion criteria. Results: Immigrant MI mortality and morbidity varied by host country with no consistent pattern from one country or region. However, there was an overall trend for increasing risk of MI among immigrants worldwide. Chinese and African immigrants had consistently higher stroke mortality. Conclusion: MI and stroke incidence and prevalence among first-generation immigrants are related to both genetic and environmental factors, but the relative contribution of each is unclear. Prospective studies are needed to identify genetic and behavioral characteristics associated with stroke among Chinese immigrant populations.