Abstract: Cardiovascular diseases(CVDs) is the leading cause of death worldwide, and vascular aging is inextricably linked to the onset and development of CVDs. Vascular morphological and functional alternations such as arterial stiffening, endothelial dysfunction and vascular remodeling that accompany the aging process of the vasculature are important drivers of many CVDs. Numerous mechanisms, such as oxidative stress, mitochondrial dysfunction, chronic low-grade inflammation, genomic instability, and protein imbalance, have been implicated in the development of vascular aging in current studies. However, recent research has brought attention to the distinct impact of perivascular adipose tissue(PVAT) on vascular biology. As an important component of the vascular system, PVAT plays a role in supporting the vasculature, while the adipokines derived from it, including adiponectin, leptin, resistin and pro-/anti-inflammatory cytokines could regulate vascular inflammation and oxidative stress, vascular remodeling and cellular senescence via an endocrine and paracrine manner. Thus, this paper reviewed the changes of PVAT secretome and their impact on vascular senescence under various pathophysiological conditions, and summarized the drugs that target PVAT to mitigate vascular aging by attenuating PVAT inflammation and oxidative stress, inducing PVAT browning, and regulating PVAT secretome, with the aim of offering fresh insight for the prevention of premature vascular senescence and related CVDs.