As a layer of specialized cells in the vascular lumen, vascular endothelial cells (VEC) are the key regulatory interface between blood and tissue, so they have also become potential targets for a variety of vascular injury factors.VEC injury is a common physiological change of many chronic diseases, and it is also the initial pathogenesis of many cardiovascular diseases including atherosclerosis. The specific mechanism remains to be further elucidated. Exploring the general pathological mechanism of VEC injury is helpful to improve the development and prognosis of cardiovascular diseases. The article reviews the general mechanism of VEC injury caused by vasoactive substances, inflammatory response, oxidative stress, coagulation system and other factors.