Vascular remodeling is an important process in the occurrence and development of aortic dilatation disease, in which the immune cell-mediated immunological inflammatory response plays a crucial role. Here, the authors address the mechanisms of the participation of mast cells (MCs) in the pathogenesis of aortic vascular remodeling, chiefly involving their participation in the aortic wall inflammation, influence on the synthesis and degradation of extracellular matrix, and activation of renin angiotensin system (RAS), as well as their relation to angiogenesis. Finally, we put forth the possible direction for future research in this field.