Inflammatory cytokine-regulated apoptosis and autophagy play pivotal roles in plaque rupture and thrombosis of atherosclerotic lesions. However, the molecular interplay between apoptosis and autophagy in vascular cells has not been investigated. Our prior study showed that human apolipoprotein L6 (ApoL6), a pro-apoptotic BH3-only member of the Bcl-2 family, was one of the downstream targets of interferon-␥ (INF␥), which sensitizes atherosclerotic lesion-derived cells (LDCs) to Fas-induced apoptosis. To investigate whether ApoL6 plays a causal role in atherosclerotic apoptosis and autophagy, in this study, we demonstrate that IFN␥ treatment itself strongly induces ApoL6, and ApoL6 is highly expressed and partially colocalized with activated caspase 3 in activated smooth muscle cells in atherosclerotic lesions. In addition, overexpression of ApoL6 promotes reactive oxygen species (ROS) generation, caspase activation, and subsequent apoptosis, which can be blocked by pan caspase inhibitor and ROS scavenger. Knockdown of ApoL6 expression by siApoL6 suppresses INF␥-and Fas-mediated apoptosis. Further, ApoL6 binds Bcl-X L , one of the most abundant anti-death proteins in LDCs. Interestingly, forced ApoL6 expression in LDCs induces degradation of Beclin 1, accumulation of p62, and subsequent attenuation of LC3-II formation and translocation and thus autophagy, whereas siApoL6 treatment reverts the phenotype. Taken together, our results suggest that ApoL6 regulates both apoptosis and autophagy in SMCs. IFN␥-initiated, ApoL6-induced apoptosis in vascular cells may be an important factor causing plaque instability and a potential therapeutic target for treating atherosclerosis and cardiovascular disease.Atherosclerosis, a chronic inflammatory disease and the principal cause of heart attack and stroke, contributes to at least 30% of all mortality in the United States (1, 2). The atherosclerotic lesion results from a dynamic interplay involving many elements of dysfunctional wound repair, including proliferation, matrix synthesis, autophagy (self-eating), and apoptosis, in response to insult of the vascular endothelial cells (ECs) 2 and smooth muscle cells (SMCs) of the artery wall (3, 4). The crosstalk between cytokines, chemokines, growth factors, oxidized lipid species/low density lipoproteins (LDLs), and reactive oxygen species (ROS) in atherosclerotic lesions determine cell survival and death (5, 6). Inflammation, based on the particular cellular context, can modulate proliferation or apoptosis (type I programmed cell death) of different cell-types, such as ECs, SMCs, and the inflammatory infiltrate (lymphocytes, and monocytes/macrophages) in atherosclerotic lesions (7,8). With regard to cell death, it has been well documented that during the early stages of lesion development, apoptosis of macrophages contributes to the accumulation of extracellular LDLs and protein debris, while in the later stages, activated SMCs encapsulate the lipid-rich regions, and their persistence contributes to collagen synthesis, matrix accu...