Lifestyles such as unhealthy dietary habits, physical inactivity and smoking are considered fundamental risk factors for cardiovascular disease. Preventive activities have been shown to reduce mortality and morbidity from cardiovascular disease. This study aimed to determine the prevalence of cardiovascular lifestyle risks and cardiovascular preventive activities among healthy government servants in Kuala Terengganu, Malaysia. A cross-sectional study was done from June to September 2013 among 121 government servants working at the Federal Complex, Kuala Terengganu. A questionnaire which consists of socio-demographic data, International Physical Activity Questionnaire (IPAQ), the dietary component of WHO STEPS and cardiovascular screening activities were used as tools. Clustering of cardiovascular lifestyle risks was defined as the presence of two or more of smoking, physical inactivity and unhealthy diet. Optimal cardiovascular screening is defined as having done the required screening for hypertension, diabetes, dyslipideamia and obesity. The study response rate was 90.9% (110 of 121). Prevalence of smoking, physical inactivity and unhealthy diet were 20%, 50% and 87% respectively. The prevalence of clustering of cardiovascular lifestyle risks was 57%. The prevalence of optimal cardiovascular screening for age was 49%. The prevalence of cardiovascular lifestyle risks among government servants in Kuala Terengganu is still high. About half of them did not have the optimal screening for cardiovascular disease. Measures need to be done to promote healthy lifestyle behaviors in the community. Effort should be made at the primary care level and public health to screen those with multiple cardiovascular lifestyle risks in order to optimize cardiovascular disease prevention.