Atherosclerosis （As） is a major cause of coronary artery disease （CAD）, and foam cells are a main reason of As, the accumulation of excess cholesterol in macrophages forms foam cells, so reducing the accumulation of cholesterol results in reducing the formation of foam cells, which may become an effective method for the treatment of As. ATP-binding cassette transporter A1 （ABCA1） mediates the transport of cellular cholesterol and phospholipids to ApoAⅠ to generate nascent HDL particles, which makes clearance of excess cholesterol from cells to the liver for excretion to the bile and feces, a process called reverse cholesterol transport （RCT）. ABCA1 can suppress inflammatory response and induce vascular endothelial cells changes, participate in oxidative stress, affect As by different metabolic pathways, and the effects of different genotypes on As is different. Therefore, ABCA1 plays an important role in the form and development of As.