The current evidence on the vasculoprotective effects of flavonoid-rich cocoa and chocolate is reviewed. Cocoa flavonoids are derived from the cacao bean, found in the fruit pod of the cacao tree, Theobroma cacao. There is growing evidence that dietary supplementation with flavonoid-rich cocoa and chocolate may be cardioprotective because of their interference in many pathophysiological mechanisms associated with atherosclerosis. Possible beneficial effects by cocoa flavonoids include: antioxidant properties, improvement in endothelial function, blood pressure lowering, decreased platelet activation and function, and modulation of immune function and inflammation. Larger, long-term clinical trials investigating the potential beneficial effects of purified flavonoids and food sources rich in flavonoids, including cocoa and chocolate, are certainly warranted.