Recent evidence suggests that vascular inflammation plays important role in the pathogenesis and the clinical evolution of atherosclerosis. Several circulating inflammatory biomarkers such as acute phase proteins, adhesion molecules and pro-inflammatory cytokines along with biomarkers, proposed the last few years, have clarified the role of inflammation in atherosclerosis. In particular a number of studies have focused on the positive predictive role of C-reactive protein in populations without prior cardiovascular disease. As regards to fibrinogen studies have shown a positive role in predicting cardiovascular events. However, the potential prognostic role of adhesion molecules and cytokines for cardiovascular events is unclear. Thus, further studies are required to evaluate the predictive role of such molecules, as well as others under investigation in states of atherosclerosis.