Zinc finger Ebox binding homeobox 1 (ZEB1) regulates the expression of target genes to protect against atherosclerosis. Endothelial dysfunction, monocyte-endothelial cell interactions, and macrophage lipid accumulation are all regulated by ZEB1. A recent study demonstrated that ZEB1 regulates intercellular adhesion molecule 1 (ICAM1) expression, increasing monocyte-macrophage adhesion and the development of atherosclerotic lesions.It seems to be complicated between ZEB1 and atherosclerosis. The diverse effects of ZEB1 might be attributed to several influences. ZEB1 can go from activating to repressing transcription by reacting to numerous inputs. Additionally, ZEB1 controls the expression of multiple target genes and influences many cell types implicated in atherosclerosis development, including endothelial cells, VSMCs, macrophages, and T cells. There are both transcriptional and posttranslational modifications to which ZEB1 responds, demonstrating that the regulation of ZEB1 is complicated. Despite this, accumulating evidence indicates that ZEB1 is an anti-atherosclerotic component. It's critical to figure out whether ZEB1 can help with RCT.Light will be shed on the involvement of ZEB1 in atherogenesis, making ZEB1 a favorable target for atherosclerosis treatment.