This article investigates what is known about how long-term testosterone use effects lipid-related cardiovascular risk markers in the female-to-male (FtM) transgender population. A literature search was conducted using health science–oriented databases, including PubMed. Articles were considered eligible for review if they were published between January 2003 and August 2013 in English language, peer-reviewed academic journals and discussed cardiovascular risks of long-term testosterone administration in the FtM population. Reference lists of the eligible articles were reviewed for additional studies. Eight studies fulfilled the inclusion criteria. The participants in the studies were mostly young and middle-aged adults who had been treated with supraphysiologic levels of testosterone for at least 1 year. There appears to no significant lipid-related change after months or years of exposure to exogenous testosterone. However, the long-term effects of testosterone administration in the older adult FtM population are not well known.