Cardiovascular disease is a worldwide main cause of morbidity and mortality. Treatment alternatives include the use of cardiovascular implants that have generated a constant search for materials, and transformation processes that provide structures similar to those that need to be replaced. Among the biomaterials available for vascular implants, silk fibroin (SF) is of great interest because it is a natural, biodegradable, biocompatible protein. In addition, SF has outstanding mechanical properties and can be easily processed by various techniques. This article presents a general review of SF, its potential use as a biomaterial for vascular applications, and modifications that improve its hemocompatibility.