Berberine is a kind of traditional Chinese medicine of treating gastrointestinal diseases. With the deepening of the research, it has been found that berberine has an important role in the prevention of coronary heart disease. Therefore, the study of berberine has become one of the focuses in research of atherosclerosis. The effect of anti-atherosclerosis of berberine and its mechanism were reviewed from regulating lipid, resistant endothelial injury, anti-inflammatory response and antithrombotic in this article.