Cerebrovascular and cardiovascular diseases (CVDs) are a major cause of deaths among workers as well as in general population in Korea. The term “Karoshi” in Japan represents work-related cerebrovascular and cardiovascular diseases (WR-CVD) due to excessive overwork. According to the Karasek's Demand-Control Model many prospective studies reported a significant association between working in jobs with high strain and increased likelihood of subsequent development of cardiovascular diseases. However, further understanding of the etiopathology of each different work-relatedness is needed to prevent WR-CVDs effectively. This review was planned to help the readers with knowledge on the etiopathology of the WR-CVDs. Based on the causal or triggering factors, work-relatedness in the literature can be classified into four types: ‘accidental type (e.g. sudden cardiac deaths)’, ‘typical Karoshi type due to extreme overwork’, ‘maladaptation type due to dramatic change in job characteristics’, and ‘job stress type due to inherent characteristics’. Even though the outcome of each type is apparently similar, their causes and pathophysiologic mechanisms are quite different. In conclusion, the work-relatedness of CVDs among employees is very limited and usually works as a trigger rather than as the causal factors. A thorough understanding of the etiopathology of WR-CVDs can be very helpful in developing a prevention strategy.