Background: Debatably, the most commonly prescribed lifestyle modification for cardiovascular health involves daily exercise training (ET) and physical activity. Exercise has numerous known health benefits on blood pressure, lipid profile, weight loss, and glucose metabolism. However, controversy exists regarding the link between excessive endurance ET and harmful cardiac effects.; Methods: We review the current literature and discuss the numerous known adverse effects of endurance ET on cardiac function.; Results: Excessive endurance ET may negatively affect cardiac anatomy, play a role in osteoarthritis and coronary artery disease development, and increase the risks of cardiac arrhythmia and sudden cardiac death.; Conclusion: More ET may not always be better when it comes to endurance ET, and optimal ET dosing regimens are clearly needed.