Hydrogen sulfide (H2S), an important gaseous signaling molecule, plays a critical role in maintaining vascular homeostasis. H2S participates in numerous biological functions, including redox regulation, interactions with other signaling molecules, and post-translational modifications of proteins through sulfhydration. Additionally, H2S influences key pathological processes such as inflammation, oxidative stress, and cell apoptosis. Dysregulation of endogenous H2S metabolism has been closely linked to the development of various vascular diseases, including aortic aneurysms, aortic dissection, atherosclerosis, and thrombotic conditions. Various endogenous and exogenous H2S donors have been developed, and these donors have demonstrated promising effects in preclinical models of vascular diseases such as atherosclerosis, pulmonary hypertension, and thrombosis by modulating oxidative stress, inflammatory pathways, and vascular remodeling. This review consolidates the current knowledge on the effects of H2S on vascular function and offers a comprehensive summary of recent advancements in the development and application of H2S donors in vascular disease research.