Cardiovascular disease is the first killer in world, and lipid metabolism disorders are the main cause of atherosclerotic cardiovascular and cerebrovascular diseases, which can lead to acute events such as myocardial infarction, stroke, acute pancreatitis, and chronic kidney disease. The rapid development of gene therapy technology has provided an effective means for the study on the mechanism of lipid metabolism and made it possible to cure the disease. Adeno-associated virus is one of the most commonly used gene delivery tools for gene therapy due to its wide host range, high safety, low immunogenicity and long-term stable expression. This article reviews the role of adeno-associated virus as gene therapy delivery vector in the study of the lipid metabolism and the lipid-lowering therapy.