Ankylosing spondylitis (AS) presents a considerable disease burden, largely due to its rheumatic nature and the increased risk of accelerated atherosclerosis, which raises the chances of cardiovascular disease (CVD). Identifying inflammatory biomarkers and cardiovascular risk factors in patients with axial spondylarthritis (axSpA) is critically important for clinical practice. Recent research has brought attention to the adipomyokine irisin, which is significant in regulating inflammatory responses and cardiovascular health. Our goal is to assess the viability of irisin as both a genetic and serological biomarker for detecting subclinical atherosclerosis, evaluating cardiovascular risk, and understanding the severity of disease manifestations in axSpA patients. By clarifying the connection between irisin levels and cardiovascular outcomes, we seek to deepen the comprehension of disease mechanisms and enhance risk stratification for this group. This understanding could lead to more focused therapeutic approaches and improved management of the comorbidities linked to AS, ultimately benefiting patient care and outcomes