Endothelial-mesenchymal transition（EndMT）plays a key role in the pathological development of atherosclerosis（AS）by contributing to plaque fibrosis and affecting plaque instability.It is crucial in the onset，progression，and outcome of AS.In-depth exploration of the potential regulatory mechanisms of EndMT in unstable plaques can aid early intervention and delay AS progression.Active compounds，derivatives，and classical prescriptions of traditional Chinese medicine can regulate endothelial cell function through various pathways，such as modulating the release of vascular active substances，antioxidative stress，anti-inflammatory effects，and balancing coagulation and anticoagulation systems，showing advantages in multiple targets and processes in the prevention and treatment of AS.The classical prescription Danshen Drink can inhibit EndMT through the LASP1/PI3K/AKT signaling axis，providing new ideas for anti-AS treatment.Various Chinese herbal monomers and classical prescriptions have multi-target effects including lipid regulation，anti-inflammation，anti -platelet aggregation，antioxidative stress，regulation of endothelial function，and inhibition of EndMT，which can synergistically delay AS progression from multiple angles.Future research should further explore the regulatory mechanisms of EndMT and its role in the progression and instability of inflammation induced AS plaques，aiming to provide important scientific evidence for developing innovative strategies to stabilize and reverse AS plaques.