To describe the cardiovascular risk profile in a representative cohort of prostate cancer patients treated with or without androgen deprivation therapy (ADT).We prospectively characterized in detail 2492 consecutive men (mean age 68 years) with prostate cancer (newly diagnosed or with a plan to prescribe ADT for the first time) from 16 Canadian sites. Cardiovascular risk was estimated by calculating Framingham risk scores.Most (92%) had new prostate cancer (intermediate-risk in 41%; high-risk in 50%). The highest level of education achieved was primary school in 12%. Most (58%) were current or former smokers; 22% had known cardiovascular disease; 16% diabetes; 45% hypertension; 31% body-mass index ≥30kg/m; 24% had low levels of physical activity; the mean handgrip strength was 37.3kg; 69% had a Framingham risk score consistent with high cardiovascular risk. Participants in whom ADT was planned had higher Framingham risk scores than those not intending to receive ADT; this risk was abolished after adjustment for confounders.Two-thirds of men with prostate cancer is at high cardiovascular risk. There is a positive association between a plan to use ADT and baseline cardiovascular risk factors; however, this association is explained by confounding factors.