Abdominal aortic aneurysm (AAA) is a hidden and fatal disease, but its underlying developmental mechanism remains unclear. Phenotypic switching of vascular smooth muscle cells and pyroptosis have been identified as biological processes closely related to the appearance and progression of AAA, with potentially important roles in the mechanism of AAA and in providing new directions for its diagnosis and treatment. In this review, we discuss phenotypic switching of vascular smooth muscle cells and the regulatory relationship between cell pyroptosis and AAA.