Hemorheology plays an important role in atherosclerosis. Hemorheologic properties of blood include whole blood viscosity, plasma viscosity, hemaocrit, RBC deformability and aggregation, and fibrinogen concentration in plasma. Blood flow is determine by three parameters (pressure, lumen diameter, and whole blood viscosity), whole blood viscosity is one of the key physiological variables. However, the significance of whole blood viscosity has not yet not been fully appreciated. Whole blood viscosity has a unique property, non-Newtonian shear-thinning characteristics, which is primarily due to the presence of RBCs. Hence, RBC deformability and aggregation directly affect the magnitude of blood viscosity, and any factors or diseases affecting RBC characteristics influence blood viscosity. Therefore, on can see that whole blood viscosity is the causal mechanism by which traditional risk factors such as hypertension, hyperlipidemia, smoking, exercise, obesity, age, and gender are related to atherogenesis. In this regard, we included whole blood viscosity in the three key determinants of injurious pulsatile flow that results in mechanical injury and protective adaptation in the arterial system. Because whole blood viscosity is a potential predictor of cardiovascular diseases, it should be measured in routine cardiovascular profiles. Incorporating whole blood viscosity measurements into a standard clinical protocol could improve our ability to identify patients at risk for cardiovascular disease and its complications.