Background: Iron deficiency leads to health problems. Conversely, iron overload induces the generation of reactive oxygen species and health problems. Body iron status contributes to the development of various diseases, including aortic disease. Indeed, several clinical studies have reported that iron status can be linked to the pathogenesis of aortic disease. At the cellular level, iron uptake is regulated by the cellular iron transporter, transferrin receptor 1, while systemic iron homeostasis is regulated by hepcidin. As body iron status is regulated to maintain cellular and systemic iron homeostasis, iron metabolism in aortic disease is puzzling and not well understood. Methods: Perspective and short communication. Conclusions: This review provides an overview of the relevant research investigating the association between cellular iron metabolism and aortic disease.