Abstract: The development of atherosclerosis (As) is closely related to inflammatory response, lipid metabolism disorders and environmental factors. Epigenetic studies are concerned with regulatory mechanisms such as DNA methylation, non-coding RNA regulation, histone modifications and chromatin remodeling. An increasing number of studies have revealed the involvement of epigenetics in the development of As. Aberrant epigenetic changes play a key role in mediating foam cell production, endothelial dysfunction, and vascular smooth muscle cell (VSMC) phenotype transformation. In this paper, we describe the regulatory mechanisms and therapeutic roles of epigenetics in As, and summarize the latest research progress, aiming to provide a reference for early diagnosis and personalized treatments of clinical As from the perspective of non-genetic factors.