Precise diagnosis of atherosclerosis (AS) is a crucial strategy for reducing acute cardiovascular events. Herein, a macrophage membrane (MM)-camouflaged biomimetic vesicle loaded with near-infrared-II (NIR-II) aggregation-induced emission luminogens (AIEgens) (P4TT@MM) is proposed to achieve localized in vivo imaging of atherosclerosis. The AIEgens characteristics of P4TT@MM effectively compensate for the fluorescence intensity decrease caused by the intramolecular torsional charge transfer (TICT) effect, even in foam cell-rich lesions. Benefiting from the biomimetic camouflage of MM and its strong affinity for atherosclerotic plaques, P4TT@MM enables precise targeting of lesion sites, successfully achieving high-contrast imaging of atherosclerotic plaques in the carotid arteries and aortas of the AS mice model. Compared with free P4TT, the NIR-II fluorescence intensity of P4TT@MM is increased by 140% in carotid arteries and 152% in aortas, respectively. Moreover, the P4TT@MM demonstrates robust biocompatibility combined with significant clinical translation potential. This study may present a promising tool for the clinical diagnosis of AS.