Background-—There are few data about the association between work-related stress and the American Heart Association ideal cardiovascular health (CVH) metrics. We studied the association between work-family conflict (WFC) and ideal CVH scores in the ELSA-Brasil (Brazilian Longitudinal Study of Adult Health) baseline study. Methods and Results-—We analyzed data of active workers (5424 men and 5967 women), aged 35 to 74 years, from 2008 to 2010. Ideal CVH scores were calculated based on the lifestyle and health metrics proposed by the American Heart Association, using data from questionnaires and clinical and laboratory examinations from the ELSA-Brasil study baseline. The WFC questionnaire was based on the Frone model, validated for Brazilian Portuguese. WFC domains (time and strain-based work interference with family, family interference with work, and lack of time for personal care and leisure) and frequency (never to rarely, sometimes, or frequently) were self-reported. Main models were adjusted for age, sex, race, educational level, income, and study site. Positive relative predicted score differences (rPSDs) indicate higher predicted scores. We found lower lifestyle ideal CVH scores among men (rPSD, 5.7%; P=0.002) and women (rPSD, 10.2%; P<0.001) with frequent lack of time for personal care and leisure. We found lower lifestyle ideal CVH scores among women with frequent strain-based work interference with family (rPSD, 5.1%; P=0.002), and family interference with work (rPSD, 8.6%; P=0.001). We found higher health ideal CVH scores among men with frequent WFC, which may be attributable to reverse causation.