Chronic periodontitis is the most common infectious periodontal disease caused by plaque biofilm. Pili is an important bacterial component of Porphyromonas gingivalis. Epidemiological studies have shown that chronic periodontitis can increase the risk of cardiovascular disease, and atherosclerosis is the pathological basis of cardiovascular disease. This article will summarize the mechanism of Porphyromonas gingivalis pili protein mediated chronic periodontitis and atherosclerosis, in order to expand new ideas of disease prevention and treatment.