Cardiovascular disease (CVD) remains the leading cause of morbidity and mortality among women worldwide, with emerging evidence suggesting that reproductive factors significantly influence long-term cardiometabolic risk. This hospital-based cross-sectional study aimed to evaluate the association between reproductive characteristics and cardiovascular risk markers among women attending a tertiary care center. A total of 312 women aged 25–65 years were enrolled between January 2022 and December 2023. Detailed reproductive histories, including age at menarche, parity, age at first pregnancy, menopausal status, history of gestational diabetes, hypertensive disorders of pregnancy, and oral contraceptive use, were recorded. Cardiovascular risk markers assessed included body mass index (BMI), waist-to-hip ratio (WHR), fasting lipid profile, fasting plasma glucose (FPG), and high-sensitivity C-reactive protein (hs-CRP). Early menarche (<12 years) was significantly associated with higher BMI (29.4 ± 4.1 kg/m² vs 26.8 ± 3.7 kg/m², p < 0.001) and elevated triglycerides (p = 0.002). Multiparity (≥3 births) correlated with increased WHR (0.91 ± 0.05 vs 0.86 ± 0.04, p < 0.001) and higher FPG (p = 0.01). Postmenopausal women demonstrated significantly elevated LDL cholesterol and hs-CRP levels (p < 0.001). History of gestational diabetes independently predicted metabolic syndrome (OR 2.8; 95% CI 1.4–5.6; p = 0.003). Reproductive factors are significantly associated with adverse cardiovascular risk markers, emphasizing the importance of incorporating reproductive history into cardiovascular risk stratification in women.