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Atherosclerosis (AS) is closely related to the pathogenesis and abnormal proliferation and migration of vascular smooth muscle cells (VSMCs). To explore the value of hsa_circ_0044097 in the clinical management of AS and to elucidate its role and mechanism in the injury of VSMCs induced by in vitro oxidized low-density lipoprotein (ox-LDL). The mRNA expressions of hsa_circ_0044097 and miR-3918 were determined using RT-qPCR, and transfection verification was also conducted. The content of IL-6 and TNF-α was determined using an ELISA kit. CCK-8 and transwell assays were performed to determine the proliferation and migration of HASMC cells. The dual luciferase reporter assay and Spearman correlation analysis were performed to verify the relationship between hsa_circ_0044097 and miR-3918. The clinical value of hsa_circ_0044097 was evaluated using the ROC curve, K-M survival analysis and Cox analysis. Hsa_circ_0044097 level was decreased in AS patients' serum and HASMCs stimulated by ox-LDL. Hsa_circ_0044097 could serve as an indicator for the diagnosis of AS and for predicting the occurrence of MACE in AS patients. Overexpression of hsa_circ_0044097 inhibited the levels of inflammatory factors, cell proliferation and migration. MiR-3918 was targeted by hsa_circ_0044097, and overexpression of miR-3918 reversed the inhibitory effect of the upregulation of hsa_circ_0044097 on the proliferation and migration of VSMCs. Hsa_circ_0044097 may be a biomarker for diagnosing AS and predicting the occurrence of MACE. Hsa_circ_0044097 influences the progression of AS.