Atherosclerosis is a chronic vascular inflammation process. Emerging studies have shown that long non-coding RNA (lncRNA) can interact with microRNA as the competitive endogenous RNA (ceRNA), and regulate the expression and function of its target genes,which plays an important role in the pathogenesis of atherosclerosis. The novel regulatory mechanisms underlying the crosstalk among lncRNA, microRNA and mRNA are complex. This review comprehensively summarized the regulatory relationship of lncRNA-microRNA-mRNA axis in the pathophysiological processes of atherosclerosis, and highlighted the important role of this axis involved in endothelial cell dysfunction, vascular smooth muscle cell phenotype transformation, macrophage activation and lipid metabolism abnormality, aiming to provide new targets for clinical treatment of atherosclerotic diseases.