HDL therapy has demonstrated beneficial effects in acute stroke and acute myocardial infarction models by reducing infarct size. In this study, we investigated the inhibitory effects of reconstituted HDL (rHDL) on neointimal hyperplasia and elucidated its underlying mechanism using a balloon injury rat model. Histological analysis of the injured arteries showed a significant 37% reduction in the intima to media ratio in the group treated with 80 mg/kg rHDL compared to the injury-only group (p<0.05), indicating a specific inhibition of neointimal hyperplasia by rHDL. In vitro analysis confirmed that rHDL significantly suppressed smooth muscle cell (SMC) proliferation while promoting endothelial cell (EC) proliferation. Moreover, treatment with rHDL resulted in reduced infiltration of leukocytes and downregulation of MMP9 expression in the neointimal area. Notably, rHDL administration led to decreased expression of VCAM1 and HIF1α, accompanied by increased expression of heme oxygenase 1 (HO1). Overexpression of HO1 by rHDL effectively inhibited SMC proliferation both in vivo and in vitro. Furthermore, rHDL-mediated suppression of injury-induced HIF1α coincided with upregulation of HO1. Interestingly, HSP27 and HO1 exerted inhibitory effects on the expression of C-C chemokine receptors (CCR2, CCR5, and CCR7), while specifically inhibiting the expression of CX3C motif chemokine receptor 1 (CX3CR1) was observed only with HO1. These findings highlight the distinct roles of HSP27 and HO1 as potential regulatory factors in the progression of restenosis. Collectively, our study demonstrates that rHDL exerts a potent anti-neointimal hyperplasia effect by suppressing leukocytes infiltration and SMC proliferation while promoting EC proliferation.