Atherosclerotic vascular disease is one of the leading cause of mortality and disability of humans, thrombosis caused by atherosclerotic vulnerable plaque rupture is a common pathological basis for the occurrence of multiple acute cardiovascular and cerebrovascular diseases. There are divergent opinions on the exact mechanism of its pathogenesis. This article focuses on the current literature on immunology, and explores the role of immune abnormalities in the development of atherosclerosis.