The incidence of cardiovascular diseases (CVD) has been increasing year by year, with atherosclerosis (As) being the leading cause in terms of both incidnce and mortality for CVD in China. Traditional theories suggest that the pathogenesis of atherosclerotic CVD is associated with endothelial dysfunction and inflammatory responses caused by the accumulation of oxidized low density lipoprotein (ox-LDL). However, recent studies have demonstrated that perivascular adipose tissue (PVAT) can positively influence the occurrence and development of CVD through the vascular adventitia pathway. This article reviews the connection between PVAT and CVD, effective pathways for promoting CVD improvement, and the regulatory role of AMP-activated protein kinase (AMPK) on PVAT, aiming to explore effective intervention targets for CVD.