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Lina Chen,1 Jie Zhou,2 Mingjian Ni,3 Yitong Ma1 1The First Affiliated Hospital of Xinjiang Medical University, Urumqi, Xinjiang, People’s Republic of China; 2Xinjiang Uygur Autonomous Region Sixth People’s Hospital, Urumqi, Xinjiang, People’s Republic of China; 3Xinjiang Uygur Autonomous Region Center for Disease Control and Prevention, Urumqi, Xinjiang, People’s Republic of ChinaCorrespondence: Mingjian Ni, Xinjiang Uygur Autonomous Region Center for Disease Control and Prevention, Urumqi, Xinjiang, People’s Republic of China, Email xjnmj@126.com Yitong Ma, The First Affiliated Hospital of Xinjiang Medical University, Urumqi, Xinjiang, People’s Republic of China, Email myt-xj@163.comAbstract: With the widespread use of antiretroviral therapy (ART), the life expectancy of people living with HIV (PLWH) has significantly improved. However, the incidence of cardiovascular disease (CVD) in this population has progressively increased. PLWH exhibit a significantly higher risk of cardiovascular diseases compared to the general population. Consequently, CVD has become one of the leading contributors to mortality not related to AIDS. The pathogenesis may involve several factors: HIV-related proteins exacerbating endothelial injury and inflammation; immune activation and chronic inflammation; adverse effects of ART; and traditional cardiovascular risk factors. Although multiple inflammatory cytokines are implicated in HIV-associated CVD, interleukin-32 (IL-32) stands out due to its distinctive multifunctional properties. Compared with other cytokines, Interleukin-32 (IL-32), a multifunctional pro-inflammatory cytokine, plays key roles in inducing the release of inflammatory cytokines, promoting endothelial dysfunction, and driving monocyte migration. IL-32 is closely associated with the development of HIV-associated CVD and shows potential as a novel biomarker and therapeutic target. This review aims to summarize recent advances in understanding the role of IL-32 in HIV-associated CVD. It also provides new insights for the diagnosis and treatment of CVD in PLWH.Keywords: IL-32, HIV, cardiovascular disease, chronic inflammation, biomarker