Atherosclerosis （As） is a chronic inflammatory and immune disease. The correlation between Helicobacter pylori （Hp） infection and atherosclerotic disease has received increasing attention. However,the clear mechanism of Hp contributing to the development of As has not been completely elucidated. Toll-like receptor 4 （TLR4） is an important pattern recognition receptor,which induces innate immunity and induction of acquired immunity by microorganism. TLR4 plays a pivotal role in the initiation and progression of atherosclerosis. TLR4 is expressed on many cells involved in the formation of As. By means of capturing lipopolysaccharide from Hp,TLR4 initiates intracellular signal pathway and leads nuclear factor-kappa B transcription and many inflammatory factors release,and results in inflammatory injury. This article makes a summary on Hp,TLR4 signal pathway and its effects on the pathogenesis of atherosclerosis,and provides an implication for prevention and treatment of atherosclerotic artery diseases.