ATP-binding cassette transporter 1 (ABCA1) mediated lipid efflux and evolved to maintain cholesterol homeostasis. Newborn ABCA1 should through intracellular transport and chemical modification, ultimately being a mature functional transporter with its function of lipid transport. The intracellular transport and correct localization of ABCA1 plays an important role in its function. ABCA1 researches focused on the lipid transport, and proposed the model of the various cholesterol efflux mechanisms, such as channel transport model, mushroom-like protuberances model and retroendocytosis model. Recent studies have shown, ABCA1 can regulate the plasma membrane lipid rafts, and involve in immune and inflammatory regulation. This review focuses on the current views on intracellular transport and various functions of ABCA1, in order to provide the new therapeutic targets for atherosclerosis-related diseases.