Piezo1 protein is a non-selective mechanically gated cation channel. Under the action of mechanical stimulation, it can cause the influx of cations such as calcium, sodium, potassium, etc., and then convert the mechanical signals into bioelectrical signals, and integrate the signals into cells to participate in a variety of physiological and pathological processes. Piezo1 protein widely exists in the cardiovascular system, and plays an important role in many cardiovascular activities, such as blood flow shear stress and vascular tension sensing, vascular development and angiogenesis, and vascular remodeling. Piezo1 can sense the changes of blood flow shear stress and vascular tension, and its expression is also affected by them, thus affecting the morphology, arrangement, synthesis, secretion, inflammation and adhesion of vascular endothelial cells. Piezo1 can also regulate the migration, inflammatory reaction and lipid phagocytosis of macrophages, and participate in regulating the occurrence and development of atherosclerosis. The proliferation of vascular smooth muscle cells is also regulated by Piezo1, which then affects the remodeling of vascular wall. This article mainly reviews the discovery, structure and function of Piezo1 channel, and its research progress in atherosclerosis, in order to provide new ideas for the prevention and treatment of atherosclerosis.