Researchers have identified two promising drug classes that target cellular senescence to combat atherosclerotic cardiovascular disease. Senolytics like dasatinib-quercetin and fisetin eliminate senescent cells by disrupting anti-apoptotic pathways including BCL-2 and PI3K/AKT. Senomorphics such as rapamycin and metformin suppress inflammatory secretions from aging cells through mTOR and NF-κB pathway modulation. Preclinical studies demonstrate these compounds reduce plaque area, limit necrotic core expansion, and improve plaque stability. This represents a paradigm shift in cardiovascular medicine, moving beyond traditional lipid-lowering approaches to address the root inflammatory drivers of vascular aging. The concept of targeting senescence-associated secretory phenotype (SASP) offers a rational strategy for the substantial population of older adults who continue experiencing cardiovascular events despite optimal statin therapy. However, the field remains in early stages with critical gaps in patient selection criteria, dosing protocols, and potential interactions with existing cardiovascular medications. The transition from promising preclinical results to clinical application will require carefully designed trials specifically in geriatric populations, where safety considerations become paramount given polypharmacy concerns.