Atherosclerosis (AS) is a common vascular disease characterized by lipid accumulation and plaque formation in arteries, with high incidence and mortality rates that severely affect global human health. Mitochondria, serving as the energy center and regulator of cells, participate in various metabolic processes within cells and exert significant influence on the occurrence and development of atherosclerosis. Mitochondrial autophagy, which describes the selective autophagy process of mitochondria, is a key mechanism for maintaining cellular mitochondrial health and plays important roles in both physiological and pathological conditions. Among these, the PINK1/Parkin-mediated pathway is the most characteristic signaling pathway and plays a crucial role in AS. Its regulation is similar to the characteristics of Yin and Yang balance, including opposition, mutual restriction, mutual dependence, and the properties of "Yang" which is driving, warming, and defending, and "Yin" which is static, cold, and inward, according to traditional Chinese medicine theory. This article, based on the theory of Yin and Yang, explores the mechanism of action of the mitochondrial autophagy PINK1/Parkin signaling pathway in AS and provides new ideas for the prevention and treatment of AS through traditional Chinese medicine and compound interventions.