Cardiovascular disease is one of the common diseases, and also is a serious threat to human health. Now cardiovascular disease has becoming the world's leading cause of death. Atherosclerosis is considered to be the basis of the onset of cardiovascular diseases. Chinese traditional medicine hirudo contains a variety of active substances which plays a multicomponent, multiple targets in the process of synergy for the prevention and treatment of many complex diseases such as cardiovascular disease. In recent years, hirudo and proprietary Chinese medicine or compound preparations containing hirudo has been widely used in the clinical treatment of cardiovascular disease. This article was mainly about the effect of hirudo on vascular endothelial cell, macrophage, and vascular smooth muscle cell in atherosclerosis.