Evidences have been increasingly provided to comfirm that lipid accumulation in cells contributes to the progression of pathogeneses. The receptor-mediated lipid uptake is the crucial step for lipid retention as scavenger receptors class-A (SR-A) is not controlled via negative feedback by cytoplasmic cholesterol and therefore it plays a fundamental role in the formation of foam cells. Along with participation in apoptosis, SR-A presents very deceitful characteristics to control immune responses during age-related degenerative pathologies such as atherosclerosis and Alzheimer's disease. It is henceforth undeniable that targeted inhibition of these receptors will be helpful in getting a step closer to individualized medicine. This review unfolds current understanding of SR-A signaling with a focus on its role in apoptosis and immune regulation during different pathologies.