Insulin resistance (IR) is one of the risk factors of cardiovascular disease. Most of the conventional methods used to evaluate IR are complex and expensive, and their clinical application is limited. The triglyceride glucose index is emerging as an IR index and has been shown to be associated with cardiovascular disease in numerous studies. This article reviews the IR mechanisms in cardiovascular disease and the progress in research of the triglyceride glucose index and cardiovascular disease in order to provide a useful guide for early detection and prevention of cardiovascular disease.