<p>Atherosclerosis (AS) is a cardiovascular disease with high mortality and disability rates, and the increasing number of cases urgently demands more effective therapeutic options. AS is characterized by complex pathogenesis and multiple complications, where single-drug therapy has limited efficacy and combination therapy increases safety risks. Natural extracts (NEs) offer advantages such as multi-target, multi-pathway effects and low side effects, showing significant potential in AS prevention and adjunctive treatment. This article systematically reviews existing studies and analyzes the advantages and limitations of NEs in cardiovascular disease management. The development of novel formulations using modern biotechnology and drug delivery systems holds promise for better AS treatment. Although challenges remain in bioavailability and pharmacokinetics, ongoing advances in extraction techniques, delivery systems, and nanotechnology warrant further research into NEs for AS therapy.</p>