Abstract: Matrine is a kind of quinazine alkaloid extracted from the root of the traditional Chinese herb Sophora flavescens. Atherosclerosis is a pathological disease characterized by fibrous proliferation of the vascular wall, chronic inflammation, lipid accumulation and immune disorder. In recent years, matrine in the treatment of atherosclerosis and its related diseases have attracted wide attention. Studies have shown that matrine plays an important role in atherosclerotic diseases by reducing blood lipids, slowing down obesity, inhibiting inflammation and protecting endothelial cells. In this paper, the action mechanism of matrine in the treatment of atherosclerosis and its related diseases is further elaborated to lay a foundation for the application of matrine in clinical treatment in the future.