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In atherosclerosis, its effects are highly dependent on cellular context rather than being uniform across the vessel wall. In macrophages, ferroptotic injury strengthens inflammatory signaling and contributes to necrotic\u2010core growth; in vascular smooth muscle cells, it impairs mitochondrial fitness, contractile phenotype maintenance, and extracellular matrix support, thereby weakening the fibrous cap; and in endothelial cells, it disrupts redox homeostasis and barrier function, facilitating lipid entry and early lesion formation. This review synthesizes recent advances in the molecular regulation of ferroptosis in atherosclerosis and emphasizes how its functional consequences differ among plaque\u2010resident cell types. We also discuss natural products and traditional Chinese medicine\u2010derived compounds as promising modulators of ferroptosis\u2010related pathways, owing to their multi\u2010target actions and potential suitability for chronic vascular intervention. By connecting mechanistic evidence with therapeutic implications, we propose that cell\u2010type\u2010aware regulation of ferroptosis, rather than indiscriminate suppression, may offer a rational strategy for plaque stabilization and cardiovascular risk reduction.<\/jats:p>\n                  <jats:p>\n                    <jats:bold>Significance:<\/jats:bold>\n                    <jats:list list-type=\"bullet\">\n                      <jats:list-item>\n                        <jats:p>Ferroptosis is increasingly recognized as an important contributor to atherosclerosis, but its vascular effects vary substantially among endothelial cells, macrophages, and vascular smooth muscle cells.<\/jats:p>\n                      <\/jats:list-item>\n                      <jats:list-item>\n                        <jats:p>This review analyzes how cell\u2010specific differences in iron handling, lipid peroxidation, and antioxidant defenses shape plaque initiation, inflammatory progression, and fibrous\u2010cap stability.<\/jats:p>\n                      <\/jats:list-item>\n                      <jats:list-item>\n                        <jats:p>We further summarize evidence that natural compounds can modulate these ferroptosis\u2010related networks and restore redox and cellular homeostasis.<\/jats:p>\n                      <\/jats:list-item>\n                      <jats:list-item>\n                        <jats:p>By linking vascular cell heterogeneity with natural product\u2010based intervention strategies, this review provides a mechanistic and translational framework for more precise targeting of ferroptosis in atherosclerosis.<\/jats:p>\n                      <\/jats:list-item>\n                    <\/jats:list>\n                  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