Macrophages are a type of phagocytes, which play a crucial role in the occurrence and development of atherosclerosis. Studies have shown that different phenotypes of macrophages play different roles in the progression of atherosclerosis. Reducing the local proliferation of pro-inflammatory macrophages and inducing macrophages to transform into an anti-inflammatory phenotype are crucial to the treatmenent of atherosclerosis in the future. This article reviews the macrophage phenotype, phenotypic regulation related signaling pathways, and therapeutic strategies targeting the regulation of macrophage phenotypes, hoping to provide new targets or avenues for the prevention and treatment of atherosclerosis.