A 2-part review on the association between noise and air pollution and cardio-metabolic disease (part 1, part 2) has been published in the European Heart Journal. The first part of the review focuses on the epidemiological evidence linking noise and air pollution with cardiovascular and metabolic disease. In particular, the evidence for interaction between these two risk factors is considered. Health effects are observed below thresholds currently assumed as safe by public policy. Part II focuses on pathophysiological mechanisms, in particular the role of inflammation, oxidative stress, and the effects on vascular function and the autonomic nervous system. Both parts of the review discuss current knowledge gaps and inadequacies as well.