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Background: Cardiovascular disease (CVD) is a leading cause of global mortality, with modifiable lifestyle factors—particularly diet—playing a critical role in prevention. Lowcarbohydrate and low-fat diets are frequently recommended to reduce obesity and improve metabolic markers associated with CVD risk. Yet, existing literature has yielded inconclusive comparisons regarding their overall effectiveness. Purpose: This research sought to evaluate the comparative effects of low-carbohydrate versus low-fat diets on cardiovascular-related metabolic markers in adults, including weight, lipid profiles, blood pressure, and fasting glucose levels, to inform evidence-based dietary recommendations. Methods: An evidence-based clinical review (EBCR) was conducted using multiple databases, including Cochrane, PubMed, and Google Scholar. Studies were selected based on predefined quality criteria using the NHLBI assessment tool. Data extraction aided in the qualitative synthesis of the included studies. Three high-quality meta-analyses that collectively included 60 randomized controlled trials and 8,607 participants. Seven primary outcomes were assessed: weight, HDL, LDL, total cholesterol, triglycerides, blood pressure, and fasting glucose. Results: Low-carbohydrate diets were associated with greater short-term weight loss, higher HDL cholesterol, and lower triglycerides compared with low-fat diets. However, these benefits were consistently accompanied by modest increases in LDL and total cholesterol. No statistically significant differences were found between either dietary approach in blood pressure or fasting glucose levels. Conclusion: Low-carbohydrate diets demonstrate favorable effects on weight loss and select lipid markers but may raise LDL cholesterol, necessitating careful monitoring in individuals at risk for hyperlipidemia or cardiovascular disease. These findings support a personalized approach to dietary counseling based on individual metabolic profiles. Further long-term studies with standardized diet definitions and expanded biomarker assessments are needed to optimize diet-based prevention strategies for CVD.