Pulmonary hypertension (PH) represents a complex cardiopulmonary vascular syndrome characterized by persistent elevation in pulmonary vascular resistance. The pathophysiological hallmarks of PH include excessive proliferation of pulmonary arterial vascular cells, enhanced extracellular matrix deposition, and inflammatory cell infiltration within the pulmonary arterial wall. Without appropriate therapeutic intervention, this progressive condition inevitably leads to right heart failure and mortality. Emerging evidence has highlighted inflammation as a critical driving force in pulmonary vascular remodeling, with particular emphasis on the role of dysregulated chemokine signaling in PH pathogenesis. This chapter comprehensively examines the advances in our understanding of how chemokine regulatory networks orchestrate the cellular mechanisms underlying pulmonary vascular remodeling to provide deeper insights into the fundamental mechanisms of PH development and progression. Furthermore, this chapter explores the translational potential of chemokines as clinical biomarkers in PH for disease diagnosis, severity assessment, and prognostic prediction, thereby establishing a framework for precision medicine approaches in PH management. Understanding the intricate relationship between chemokine signaling and PH pathobiology not only advances our theoretical knowledge but also opens new avenues for targeted therapeutic interventions, potentially revolutionizing treatment strategies for this devastating disease.