Atherosclerosis (As) is a chronic inflammatory disease of complex evolutionary caused by multiple factors. Lipid accumulation is one of the key pathological factors of As, which leads to the formation of As plaques by stimulating inflammatory cell infiltration, endothelial cell injury, foam cell formation and VSMC migration and proliferation. Lipophagy as a selective process of autophagy, it can selectively degradate intracellular lipid droplets via lysosome-mediated and reduce lipid deposition and maintain intracellular lipid homeostasis, which can be used as a new target for As research.This artical discusses the research progress on the role of lipophagy in As and related traditional Chinese medicine treatment to provide feasible ideas for traditional Chinese medicine preventing and treating As from the view of lipophagy.