Lipid accumulation and inflammatory reaction play a key role in the process of atherosclerosis, which promote and influence each other. The Adipophilin as cytoplasmic lipid droplets of imperfect-coating protein, not only can be used as a marker of atherosclerotic lipid accumulation, but also can promote lipid accumulation, and inhibit the efflux of intracellular cholesterol, and mediate the secretion of some inflammatory mediators, such as TNF-α, MCP-1 and IL-6, and its expression is regulated by various factors, like the nuclear receptors, fatty acid, modified lipoprotein and hormone-like substance. The purpose of this paper is to make an overview of how Adipophilina plays a role in lipid accumulation and inflammatory response in order to help find a new thought about preventing Atherosclerosis through regulating.