Perivascular adipocytes in the vascular adventitia are considered a special type of endocrine cells that can not only respond to inflammatory stimulation，but also communicate with the sympathetic nervous system and adjacent vascular cells，thereby releasing adipokines and other signaling mediators to maintain vascular homeo⁃stasis. Perivascular adipocytes exhibit phenotypic heterogeneity（both white and brown adipocytes）and may become dysfunctional in diet-induced obesity，promote vascular inflammation，vasoconstriction，and proliferation of smooth muscle cells，and participate in the progression of vascular diseases. The role of perivascular adipocytes in regulat⁃ing vascular function has become a recent research hotspot，while the mechanism of its effect on vascular diseases remains unclear. This article discusses the mechanism of perivascular adipocytes in regulating vascular diseases， with a focus on recent findings and limitations of the current research field.