Atherosclerosis (As) is a chronic inflammatory disease in which adaptive immune cells play an important role, including immune cells and cytokines that regulate the balance between pro-inflammatory and anti-inflammatory. Traditional Chinese medicine is widely used in the prevention and treatment of As due to its advantages of multiple pathways and targets. In this paper, the mechanism of synergistic pro-inflammatory and anti-inflammatory effects of different immune cell subsets in As inflammatory response and the influence of traditional Chinese medicine regulating immune balance on As were reviewed.