Atherosclerosis is the main pathological basis of coronary heart disease, and is thus of great importance in terms of the prevention and treatment of coronary heart disease. Neuropilin-1 (NRP1), a member of the neuropilin receptor family, is closely associated with various growth factors, including vascular endothelial growth factor (VEGF) and transforming growth factor-β (TGF-β). NRP1 influences the progression of atherosclerosis through its crucial roles in angiogenesis and inflammatory responses, and sensing of wall shear stress on the vascular endothelium. This review thus explores the mechanisms underlying the role of NRP1 in atherosclerosis and the development of NRP1-targeted therapeutic strategies, to provide new insights into the diagnosis and treatment of atherosclerosis.