Molecular and cellular immune activities have a fundamental role in all stages of the atherosclerotic process and in the pathogenesis of cerebrovascular and cardiovascular diseases. Recent studies have demonstrated how chronic infections can support a local and systemic chronic inflammation, leading to the atherosclerotic process. The pathogenic link between infection and cardiovascular and cerebrovascular disease is not completely defined. Some therapeutic strategies, able to influence the persistence of the infections or to modify the inflammatory process, could be useful in primary and secondary vascular disease prevention and in modifying the acute event outcome.