Cardiovascular diseases (CVDs) are the leading global cause of death, and their prevalence in South Africa is alarmingly high, trailing only behind HIV/AIDS. Addressing physical inactivity, a key risk factor for CVDs, is crucial. This study focused on understanding how the perceived walkability of the built environment in South African townships in the Cape Town Metro affects CVD risk among a representative sample of female community health workers (CHWs). Using a survey informed by a literature review, the study gathered data on sociodemographic factors, health information, and perceptions of walkability, alongside physical measurements to assess CVD risk. Analysis revealed no statistically significant association between perceived walkability of the built environment and CVD risk among the 126 female CHWs studied. The lack of significance was consistent across the different townships. While the findings did not demonstrate a significant link between walkability and CVD risk, they point to the need for prospective studies with larger and more controlled sample populations to better understand the causal relationships between the walkability of the built environment and CVD risk.