Advances in Atherosclerosis Theranostics: Harnessing Iron Oxide-Based Nanoparticles Atherosclerosis, a chronic inflammatory disease, significantly impacts cardiovascular health. Current management strategies face challenges in early detection, plaque stability assessment, and effective treatment. Nanotheranostics, combining advanced imaging with targeted therapy, offer novel solutions. Iron oxide nanoparticles (IONPs) are promising due to their MRI capabilities and biosafety. This review discusses IONP-based nanotheranostics in atherosclerosis, covering disease pathology, targeting strategies, and diagnostic/therapeutic roles. It also explores chemical, physical, and biological therapies using IONPs, highlighting challenges and future prospects. Atherosclerosis develops through endothelial dysfunction, lipid deposition, and inflammatory responses. Early stages involve endothelial activation and ox-LDL accumulation, leading to foam cell formation. Intermediate stages feature necrotic cores and fibrous caps, while advanced stages involve vulnerable plaques prone to rupture. IONPs target various cells, including endothelial cells, macrophages, VSMCs, and platelets, using specific biomarkers and ligands. IONPs are used in MRI for early diagnosis and as drug carriers for therapies like ultrasound, photothermal, and photodynamic therapy. They enhance MRI sensitivity and enable targeted drug delivery. IONPs are also used in anti-inflammatory and anti-angiogenic therapies, with studies showing their effectiveness in reducing plaque instability and inflammation. Natural medicines and inorganic nanoparticles, such as cerium oxide, are also explored for their anti-atherosclerotic effects. IONPs combined with cerium oxide nanoparticles show promise in ROS scavenging and MRI imaging. Physical stimulation therapies, including PDT, PTT, MHT, and ultrasound, are also evaluated for their therapeutic potential. This review highlights the potential of IONPs in atherosclerosis theranostics, emphasizing their role in early diagnosis, targeted therapy, and improved treatment outcomes. Challenges include optimizing nanoparticle stability, enhancing targeting efficiency, and validating clinical applications. Future research aims to develop more effective and safe IONP-based therapies for atherosclerosis.Advances in Atherosclerosis Theranostics: Harnessing Iron Oxide-Based Nanoparticles Atherosclerosis, a chronic inflammatory disease, significantly impacts cardiovascular health. Current management strategies face challenges in early detection, plaque stability assessment, and effective treatment. Nanotheranostics, combining advanced imaging with targeted therapy, offer novel solutions. Iron oxide nanoparticles (IONPs) are promising due to their MRI capabilities and biosafety. This review discusses IONP-based nanotheranostics in atherosclerosis, covering disease pathology, targeting strategies, and diagnostic/therapeutic roles. It also explores chemical, physical, and biological therapies using IONPs, highlighting challenges and future prospects. Atherosclerosis develops through endothelial dysfunction, lipid deposition, and inflammatory responses. Early stages involve endothelial activation and ox-LDL accumulation, leading to foam cell formation. Intermediate stages feature necrotic cores and fibrous caps, while advanced stages involve vulnerable plaques prone to rupture. IONPs target various cells, including endothelial cells, macrophages, VSMCs, and platelets, using specific biomarkers and ligands. IONPs are used in MRI for early diagnosis and as drug carriers for therapies like ultrasound, photothermal, and photodynamic therapy. They enhance MRI sensitivity and enable targeted drug delivery. IONPs are also used in anti-inflammatory and anti-angiogenic therapies, with studies showing their effectiveness in reducing plaque instability and inflammation. Natural medicines and inorganic nanoparticles, such as cerium oxide, are also explored for their anti-atherosclerotic effects. IONPs combined with cerium oxide nanoparticles show promise in ROS scavenging and MRI imaging. Physical stimulation therapies, including PDT, PTT, MHT, and ultrasound, are also evaluated for their therapeutic potential. This review highlights the potential of IONPs in atherosclerosis theranostics, emphasizing their role in early diagnosis, targeted therapy, and improved treatment outcomes. Challenges include optimizing nanoparticle stability, enhancing targeting efficiency, and validating clinical applications. Future research aims to develop more effective and safe IONP-based therapies for atherosclerosis.