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Atherosclerosis(AS) is a major cause of cardiovascular and cerebrovascular diseases, with plaque formation and rupture commonly resulting in severe acute cardiovascular events. This study elucidated the spatiotemporal correlations between modern pathological mechanisms of AS and the evolution of traditional Chinese medicine(TCM) pathogenesis from the perspective of the "deficiency, stasis, and toxicity" theory. The temporal progression revealed that AS developed in three dynamic stages, including "deficiency damage" "stasis damage" and "toxicity damage". In the early stage, lipid metabolism disorders related to vascular endothelial aging served as the initial trigger. The mid-stage was characterized by an inflammatory cascade mediated by macrophages, which drove plaque progression. In the terminal stage, the disease manifested as a systemic inflammatory response and multi-organ dysfunction. The spatial aspect of the disease progression showed that the pathological damage of AS extended from "local lesions" to "regional enlargement" and finally to "systemic involvement". The pathological process of AS began with the local "deficiency damage" stage of endothelial dysfunction, followed by foam cell aggregation and macrophage infiltration to form the "stasis and toxicity interlock" lesion, leading to pathological damage that spread from local blood vessels to multiple organs. Based on the spatiotemporal evolution mechanism of "deficiency, stasis, and toxicity", a staged TCM treatment approach was proposed: tonifying deficiency and consolidating body resistance in the early stage, activating blood and resolving stasis in the mid-stage, and detoxifying and unblocking collaterals in the terminal stage. This study integrates modern pathological mechanisms with TCM theory, offering spatiotemporally precise TCM treatment modalities for the treatment of AS.