Autophagy is a metabolic process for the degradation of damaged organelles or proteins in the cytoplasm via the lysosomal system. A moderate amount of autophagy has a protective effect for atherosclerosis, but excessive autophagy can lead to cell death that is not conducive to the stability of the plaque. Traditional Chinese medicine can prevent and treat atherosclerosis through many channels and multiple targets integration, which mechanism is probably related to the regulation of atherosclerosis cell autophagy. This paper is to summarize the dual role of autophagy in atherosclerosis, regulation of autophagy on the significance of intervention of atherosclerosis, the influence of traditional Chinese medicine of autophagy and its potential significance in the prevention of atherosclerosis.