Abstract: Metabolic cardiovascular diseases are a category of cardiovascular conditions driven by metabolic risk factors, such as obesity, hypertension, metabolic-associated fatty liver disease (MAFLD), and diabetes, in which metabolism disturbance and inflammatory responses are key contributors. Peroxisome proliferator-activated receptor α (PPARα), a member of the nuclear receptor superfamily, plays a critical role in the maintenance of metabolic homeostasis. Recent studies have indicated that PPARα exerts beneficial effects on metabolic cardiovascular diseases via regulating lipid metabolism, inflammatory responses, and mitigating oxidative stress. This review summarized the molecular structure and biological functions of PPARα, with a focus on the underlying mechanisms in PPARα regulating metabolic cardiovascular diseases and translational significance of PPARα agonists in preclinical-clinical studies, aiming to establish novel therapeutic paradigms for these disorders.​