〔Abstract〕 Atherosclerosis (AS) is a chronic and inflammatory vascular disease. Macrophages are common immune cells and play an important role in the development of AS. In recent years, research has found that the formation of AS plaques is closely related to pathological and physiological processes such as macrophage polarization, energy metabolism, and lipid phagocytosis. This review aims to summarize the mechanism of macrophages in the development of AS, and to explore potential therapeutic methods for delaying AS by regulating macrophages, providing new ideas for the treatment and research of AS.