Abstract: The increasing prevalence of chronic diseases such as obesity, cardiovascular disease and diabetes has been a severe public health challenge worldwide. A large number of clinical and experimental studies have confirmed that microvascular dysfunction is not only closely associated with obesity-related target-organ damage but is also a high risk factor for cardiovascular events such as hypertension and insulin resistance. In this review we will focus on the correlation between microvascular dysfunction and obesity, hypertension and insulin resistance, as well as its underlying mechanisms.