This review explores atherosclerosis, a systemic and chronic arterial disease underlying most cardiovascular disorders. It highlights the role of inflammation in its pathophysiology, emphasizing the importance of early detection and prevention. The review discusses the progression of atherosclerotic lesions, focusing on carotid atherosclerosis, its epidemiology, clinical implications, and association with cognitive decline. Prevention strategies, lifestyle modifications, and risk factor management are critical for managing cardiovascular complications. The review also addresses the role of inflammation in atherosclerosis, including the involvement of macrophages, T cells, and chemokines. It highlights the importance of understanding the inflammatory pathways in atherosclerosis and their implications for clinical practice. The review also discusses the use of anti-inflammatory treatments, such as Canakinumab and Colchicine, in reducing the inflammatory component of atherosclerosis. The review concludes with the importance of early diagnosis and tailored treatment strategies in managing atherosclerosis and its complications.This review explores atherosclerosis, a systemic and chronic arterial disease underlying most cardiovascular disorders. It highlights the role of inflammation in its pathophysiology, emphasizing the importance of early detection and prevention. The review discusses the progression of atherosclerotic lesions, focusing on carotid atherosclerosis, its epidemiology, clinical implications, and association with cognitive decline. Prevention strategies, lifestyle modifications, and risk factor management are critical for managing cardiovascular complications. The review also addresses the role of inflammation in atherosclerosis, including the involvement of macrophages, T cells, and chemokines. It highlights the importance of understanding the inflammatory pathways in atherosclerosis and their implications for clinical practice. The review also discusses the use of anti-inflammatory treatments, such as Canakinumab and Colchicine, in reducing the inflammatory component of atherosclerosis. The review concludes with the importance of early diagnosis and tailored treatment strategies in managing atherosclerosis and its complications.