Aging plays a central role in the development of atherosclerosis and the related diseases, which pose a great threat to the people′s health. Aging is associated with the onset of atherosclerosis by the following mechanisms:(1) endothelial dysfunction as a consequence of aging impedes renewal of damaged endothelial cells; (2) disordered lipid metabolism as a consequence of aging induces more production of oxidized low-density lipoprotein; (3) aging can also stimulate the migration of vascular smooth muscle cells, change their phenotype, and compromise their proliferation ability, thus increasing vulnerability of the plaques because of the thin fibrous cap. At present, anti-aging machineries can be beneficial against the above pathophysiological processes, such as telomere repair, correction of the mitochondrial function, repair of the damaged DNA or enhancement of the anti-aging protein expression, helping to prevent the development and onset of atherosclerosis.