Atherosclerosis is a dangerous condition that leads to heart attacks and strokes when fatty lesions grow in blood vessel walls. Macrophages, essential for removing excess cholesterol, become dysfunctional due to the buildup of cholesterol, worsening the condition. Aging plays a significant role in this process, affecting cholesterol transport and mitochondrial function. Recent research suggests that improving mitochondrial function could potentially help in combating atherosclerosis. Mitochondrial dysfunction is linked to oxidative stress, inflammation, and lipid deposition, all of which contribute to the progression of atherosclerosis. Understanding the impact of mitochondrial dysfunction on critical cells involved in atherosclerosis, such as endothelial cells, vascular smooth muscle cells, and macrophages, is crucial in developing effective strategies against this chronic disease.