Atherosclerosis is a common cardiovascular disease with high mortality. Heparanase is an endogenous β-D-glucuronidase that can cleave the upper side chain of acetylproteoglycan sulfate in the outer membrane of the cell. And its non-enzymatic activity also plays a role in many normal physiological activities or pathological diseases. Studies have shown that heparanase is closely related to the formation and progression of atherosclerosis. This paper reviews the effects of heparanase on endothelial injury, coagulation, inflammatory factors and lipid accumulation, and expounds its role and mechanism in the occurrence and development of atherosclerosis.