Autophagy is a lysosomal degradation pathway for cellular homeostasis. Recent research has shown that macrophage autophage inhibits progression of atherosclerosis by promoting efflux of cholesterol and restraining inflammasome activation. However macrophage autophagy is defective in the advanced plaques,which results in increasing of plaque vulnerability and risk of plaque rupture to cause acute coronary syndrome. Afterwards how to regulate the macrophage autophage in plaque turns out to be a hot spot in the management of atherosclerosis. Further investigation on the mechanism of macrophahe autophagy may provide new ideas for the prevention and treatment of atherosclerosis.