<p>Cardiovascular diseases remain a global health challenge, with &gt;600 million cases reported annually. Atherosclerosis is a common pathology that underlies various cardiovascular diseases, such as myocardial infarction and stroke. Both the innate and adaptive immune systems have crucial roles in the progression of atherosclerosis. CD8⁺ T cells are the most clonally expanded adaptive immune cells in human atherosclerotic plaques, but whether these cells are pro-atherogenic or atheroprotective during the different stages of atherosclerosis development and progression is unclear. In this Review, we summarize the latest knowledge on the role of CD8⁺ T cells in atherosclerosis. We discuss the phenotypic, functional and transcriptional features of CD8⁺ T cells in atherosclerosis and shed light on their involvement in comorbidities to understand the landscape of CD8⁺ T cells during the progression of atherosclerosis. We also highlight key research gaps and questions that need to be addressed to improve our understanding of the functions of CD8⁺ T cells in atherosclerosis. Targeting CD8⁺ T cells could provide potential therapeutic avenues to prevent and mitigate adverse cardiovascular events in patients with atherosclerosis and coronary heart disease.</p>