Intracranial atherosclerosis (ICAS) is an important etiology of ischemic stroke and has a complex pathogenesis. Iron is an essential trace element for maintaining normal physiological functions of the human body, and the regulation of iron homeostasis is of great significance for ensuring proper physiological activities. Studies in recent years have shown that iron metabolism disorder plays a pivotal role in the development and progression of intracranial atherosclerotic cerebral infarction, involving various pathological processes such as inflammatory response, cell death, lipid metabolism, and blood-brain barrier dysfunction. This article systematically elaborates on the mechanisms through which iron overload promotes ICAS, including oxidative stress, inflammatory response, and lipid peroxidation,with a focus on the key role of related molecular mechanisms (including glutathione depletion, inhibition of GPX4 activity, and lipid peroxide accumulation)in intracranial atherosclerotic cerebral infarction, in order to provide new ideas for the prevention and treatment of intracranial atherosclerotic disease.