For the past few years, a unique type of adipose tissue, surrounding all of our cardiovascular system but cerebrovascular, known as perivascular adipose tissue (PVAT), has been seen as a new kind of adipose tissue different from the classic visceral fat due to its unusual anatomic location and function. It exerts a bidirectional effect on the cardiovascular system through the release of vasoconstrictive/relaxant adipokine in a paracrine / endocrine manner、the induction of inflammation and the change of its phenotype, including the protectional role under its physiological state and the deleterious influence under its pathological state. It also shows a potential role in the diagnosis and treatment of cardiovascular disease（CVD） as a new parameter and intervention. In this article, we will discuss its characteristics distinguished from classic adipose tissue and its effect on CVD under physiology/pathology conditions, also, its application in CVD diagnosis and treatment.