Angiotensin-converting enzyme (ACE) gene encodes ACE, an enzyme of the renin-angiotensin system (RAS) that plays a significant role in homeostasis and control of blood pressure. It seems that genetic variations can affect ACE function and cause atherosclerosis, one of the most common diseases worldwide, especially in developed countries and one of the leading causes of death in these countries. The presence of ACE insertion/deletion (I/D) affect the function of ACE. This polymorphism can lead to progression of atherosclerosis in some population. Directory of Open Access Journals (DOAJ), Google Scholar and PubMed of the most common diseases worldwide. Additionally, EBSCO and Web of Science have been searched. In this review, we studied the effects of ACE I/D polymorphism in various populations and its influence on the risk of onset and progression of atherosclerosis. Depending on the population and the area under study, polymorphisms can contribute to the risk of disease.