Background/Objectives: Contemporary data on patients attending cardiology outpatient clinics in Spain are scarce. We aimed to characterise cardiovascular conditions, cardiometabolic burden, risk-factor control and treatment patterns. Methods: RIESCAR is a national, multicentre, observational study. This analysis included 2808 adults evaluated in 50 general cardiology outpatient clinics. Results: Hypertension was present in 60.3%, dyslipidaemia in 58.9%, type 2 diabetes mellitus in 24.7%, obesity in 32.4%, and central obesity in 48.7%. Established cardiovascular disease was documented in 59.7%, with coronary artery disease (30.0%), atrial fibrillation (18.2%) and heart failure (11.7%) being the most frequent conditions. Among hypertensive patients, 42.6% had blood pressure ≥ 140/90 mmHg. In patients with established atherosclerotic cardiovascular disease (ASCVD), 37.2% achieved LDL-C < 55 mg/dL. Patients received a high number of cardiovascular drugs (mean 3.9). Among patients with a potential clinical indication for contemporary cardiometabolic therapies, SGLT2 inhibitors and GLP-1 receptor agonists were used in 35.4% and 8.6%, respectively. Conclusions: Patients attending cardiology clinics in Spain have a high cardiometabolic burden, with important gaps in blood-pressure and LDL-C target attainment. Use of contemporary cardiometabolic therapies remains variable, highlighting opportunities to strengthen cardiovascular prevention in routine practice.