Berberine is a traditional Chinese herbal medicine. As a long term clinical antimicrobial drug, it has been used in treating bacterial diarrhea. In recent ten years, the domestic and foreign scholars have extensively studied on anti-atherosclerosis of berberine. In this paper, improvement of blood lipids of berberine and its mechanism of anti-atherosclerosis are reviewed from regulating blood plasma lipids, suppressing the formation of atheromatous lipid plaque on the arterial wall, and so on.