Dendritic cells (DCs) are a key component of the immune system which are capable of sampling antigen and present them to immune effector cells. By modulating the degree and quality of response of these effector cells, DCs represent a decisive element at the earliest phases of any given immune reaction. Recently, the presence of a vascular associated DC system has been described within the vascular wall, more precisely, in the intima and adventitia. These DCs exert important (patho-) physiological functions. For instance, DCs are functional at early stages of atherosclerosis and they contribute to atheroprogression and plaque destabilization. Furthermore, DCs are involved in other inflammatory vascular diseases such as giant cell arteriitis and idiopathic pulmonary hypertension. This review describes recent advances in the physiology and pathophysiology of dendritic cells associated with the vascular wall.