Background-Atherosclerosis is driven by synergistic interactions between pathological biomechanical, inflammatory and lipid metabolic factors. Our previous studies demonstrated that absence of caveolin-1 (Cav1)/caveolae in hyperlipidemic mice strongly inhibits atherosclerosis, which was attributed to activation of endothelial nitric oxide synthase (eNOS) and increased production of nitric oxide (NO), reduced inflammation and low-density lipoprotein (LDL) trafficking. However, the contribution of eNOS activation and NO production in the athero-protection of Cav1 and the exact mechanisms by which Cav1/caveolae controls the pathogenesis of diet-induced atherosclerosis are still not clear. Methods-Triple knockout mouse lacking expression of eNOS, Cav1 and Ldlr were generated to explore the role of NO production in Cav1-dependent atheo-protective function. The effects of Cav1 on lipid trafficking, extracellular matrix (ECM) remodeling and vascular inflammation were studied both in vitro and in vivo using a mouse model of diet-induced atherosclerosis. The expression of Cav1 and distribution of caveolae regulated by flow were analyzed by immunofluorescence staining and transmission electron microscopy. Results-We found that absence of Cav1 significantly suppressed atherogenesis in Ldlr −/− eNOS −/− mice, demonstrating that athero-suppression is independent of increased NO production. Instead, we find that absence of Cav1/caveolae inhibited LDL transport across the endothelium, pro-atherogenic fibronectin deposition, and disturbed flow-mediated endothelial cell (EC) inflammation. Consistent with the idea that Cav1/caveolae may play a role in early flowdependent inflammatory priming, distinct patterns of Cav1 expression and caveolae distribution were observed in athero-prone and athero-resistant areas of the aortic arch even in wild-type mice. Conclusions-The above findings support a role for Cav1/caveolae as a central regulator of atherosclerosis that links biomechanical, metabolic and inflammatory pathways independent of endothelial eNOS activation and NO production.