Atherosclerosis is an important factor in cardiovascular events. Relevant epidemiological surveys show that the burden of atherosclerotic cardiovascular disease in China has increased rapidly and significantly in recent years, which has brought major challenges to China's public health problems. Myocardin-related transcription factor-A (MRTF-A) plays an important role in the development of atherosclerosis, including participating in inflammatory responses, promoting lipid accumulation, and phenotypic transformation of vascular smooth muscle cells (VSMC) in the process of atherosclerosis, and exploring the correlation between MRTF-A and atherosclerosis is of great significance for finding new therapeutic targets. This article reviews the role of MRTF-A in the process of atherosclerosis lesions, which can provide a reference for targeted therapy of coronary atherosclerosis.