Aging leads to progressive deterioration of the structure and function of arteries, which eventually contributes to the development of vascular aging-related diseases. N-methyladenosine (mA) is the most prevalent modification in eukaryotic RNAs. This reversible mA RNA modification is dynamically regulated by writers, erasers, and readers, playing a critical role in various physiological and pathological conditions by affecting almost all stages of the RNA life cycle. Recent studies have highlighted the involvement of mA in vascular aging and related diseases, shedding light on its potential clinical significance. In this paper, we comprehensively discuss the current understanding of mA in vascular aging and its clinical implications. We discuss the molecular insights into mA and its association with clinical realities, emphasizing its significance in unraveling the mechanisms underlying vascular aging. Furthermore, we explore the possibility of mA and its regulators as clinical indicators for early diagnosis and prognosis prediction and investigate the therapeutic potential of mA-associated anti-aging approaches. We also examine the challenges and future directions in this field and highlight the necessity of integrating mA knowledge into patient-centered care. Finally, we emphasize the need for multidisciplinary collaboration to advance the field of mA research and its clinical application.