Atherosclerosis is the leading cause of cardiovascular and cerebrovascular diseases caused by smoking, hypertension, aging, obesity, circadian clock disorders, and other factors. As a molecular machine for protein synthesis, ribosomes maintain protein homeostasis in cells. This review focuses on the impact of aging, obesity, and circadian clock disorders on the development of atherosclerosis and the relationship with ribosome biogenesis and provides the theoretical basis for both basic research and clinical intervention of atherosclerosis.