Based on the pathophysiology and clinical trials of different lipoprotein subtypes, this review systematically examines their distinct biological roles in disease development and progression, alongside their interactions with other lipoproteins and apolipoproteins, aiming to present the latest clinical advances concerning their roles in cardiovascular and other diseases, with a focus on Lp(a)-lowering therapies and recent breakthroughs in emerging treatments, while exploring the future potential and mechanisms of Lp(a) in cardiovascular diseases (beyond ASCVD and AS) and other diseases. Here, LPA is linked to atherosclerosis.