Abstract: Cardiovascular disease (CVD) is one of the leading causes of death in the Chinese population. Epicardial adipose tissue (EAT) is a unique fat depot located between the myocardium and visceral pericardium, which plays roles in cardiovascular diseases through pro-inflammatory, pro-fibrotic, neuromodulatory, glucose and lipid metabolism disorders, and is an important risk factor in cardiovascular diseases, as well as a new target for the treatment of cardiovascular diseases. In this paper, the roles of EAT in the occurrence and development of coronary artery disease, atrial fibrillation, heart failure andhypertensionare described; and the possibility of targeted therapy with EAT to change the prognosis of cardiovascular disease is explored.