Based on the mechanical, cavitation and biochemical effects of ultrasound in the organs and tissues, ultrasound intervention can effectively ablate the plaques or thrombi in blood vessels. In this paper, we focused on the ultrasound intervention treatment of atherosclerotic cardiovascular disease (ASCVD) and reviewed the effect of treatment methods and parameters on the efficacy and safety, discussing some recent clinical, in vivo and in vitro experimental researches. Low-frequency (<300 kPa) ultrasound causes severe bleeding due to the generation of standing waves and large cavitation bubbles that induce high stress on the vessel wall. High frequencies (>3 MHz) lead to the attenuation of acoustic pressure, reducing the therapeutic efficacy. In general, the frequency of 0.8-2 MHz is used for clinical treatment while guaranteeing therapeutic efficacy and safety. In order to avoid side effects such as tissue damage and temperature rise at high intensity, low-intensity (0.7-1.25 W/cm²) ultrasound was employed in clinical trials. Ultrasound pulse parameters and exposure time should be determined in relation to the lesion, ultrasound intensity and frequency. In ultrasound therapy, the administration of drugs (rtPA, atorvastatin, tongxinluo, streptokinase, urokinase) and microbubbles (MBs) encapsulated by a lipid shell, such as ultrasound contrast agent (UCA), provides an opportunity to further enhance the therapeutic effects. Their concentration and dosage used in treatment varied depending on the treatment object, and they should be reasonably selected considering adverse effects including hemorrhage. The debris removed from plaques should be small enough (<10 μm) not to cause blockage of the capillaries. Otherwise, a suction technology that can collect the debris in the vessel must be incorporated with this ultrasound technology. In addition, it is necessary to combine a monitoring system that can evaluate and monitor the degree of tissue damage in real time during treatment. Magnetic resonance imaging (MRI) and computed tomography (CT) can be combined to detect the sign of bleeding, while a thermocouple, ultrasound imaging, infrared thermal imaging and MRI can be used to predict the thermal damage by measuring tissue temperature invasively or non-invasively.