BACKGROUND Non-functioning adrenal adenomas (NFA) are prevalent tumors often associated with metabolic disturbances compared to the general population. This study aimed to evaluate cardiovascular disease (CVD) risk in 106 patients with NFA using SCORE2 and SCORE2-OP algorithms. MATERIAL AND METHODS The study sample comprised of 106 patients with NFA. CVD risk was assessed using SCORE2 and SCORE2-OP charts. The study population was divided across different categories: low-to-moderate risk, high-risk, very high-risk of CVD. Anthropometric measurements, metabolic indices, lipid profiles, and carbohydrate metabolism parameters were analyzed across different CVD risk groups. RESULTS Very high-risk patients had a higher waist-to-hip ratio (WHR) value (0.95; 0.89-0.98) compared to low-to-moderate risk patients (0.89; 0.84-0.91; P=0.0049). Also, high-risk patients had a higher WHR value (0.92; 0.87-0.97) compared to low-to-moderate risk patients (0.89; 0.84-0.91; P=0.032). Patients with low-to-moderate CVD risk had significantly lower fasting glucose levels compared to patients with high CVD risk (5.35; 5.08-5.61 vs 5.78; 5.39-6.03; P=0.0093) as well as compared to patients with very high risk (5.35; 5.08-5.61 vs 5.83; 5.22-6.28; P=0.0230). There was no significant difference in lipid parameters and atherogenic indices between the groups based on CVD risk according to SCORE2 and SCORE2-OP. CONCLUSIONS Elevated fasting glucose levels are significantly associated with higher CVD risk in NFA patients, particularly in high and very high-risk group. Systolic blood pressure and WHR were identified as cost-effective measures for predicting of CVD among NFA patients. Metabolic indices did not show any significant differences across CVD risk groups.