Understanding the processes involved in the formation and progression of clinically dangerous and vulnerable atheromas, which are the cause of cardiovascular events, is an important goal of cardiovascular disease research and treatment. In atherosclerotic lesions, macrophage cell death is the most critical cellular event involved in the formation and growth of the lipid core, as well as the thinning of the fibrous cap. Cell death by necrosis stimulates the lesion cells and arouses inflammation, destabilizing the atheroma and expanding the lipid core. Previously, it was thought that cell death was caused by either apoptosis or accidental necrosis, but recent studies have revealed the existence of several other types of cell death, and cells are dying through multiple distinct pathways.