Purpose of Review <p>This review explores current knowledge on the beneficial and detrimental roles of nitric oxide (NO) in vascular biology, with a particular focus on the emerging role of protein S-nitrosylation in the pathophysiology of atherosclerosis.</p> Recent Findings <p>Major risk factors for atherosclerosis include hypercholesterolemia, low-density lipoprotein (LDL) oxidation, hyperglycemia, hyperhomocysteinemia, chronic inflammation, and obesity. Recent studies have shown that protein S-nitrosylation interacts with these risk factors, influencing atherogenesis either by promoting or inhibiting disease progression.</p> Summary <p>Atherosclerosis is a chronic inflammatory disorder marked by the accumulation of plaques within arterial walls, arising from intricate interactions among endothelial cells, monocytes/macrophages, and vascular smooth muscle cells. Understanding the role of S-nitrosylation in regulating key cellular events—such as endothelial dysfunction, foam cell formation, and vascular smooth muscle cell proliferation—offers new insights into the molecular mechanisms underlying atherosclerosis. These insights may ultimately lead to the identification of novel therapeutic targets for cardiovascular disease.</p>