Endometriosis is a complicated and chronic inflammatory disease. Despite the fact that several therapeutic strategies for the treatment of endometriosis have been established，there is a high recurrence rate after drug and surgical treatments.Macrophages are the primary immune cells in the human body，and recent research has found that macrophage recruitment in endometriotic lesions，as well as their polarized phenotype，contribute to the development and maintenance of endometriosis. The role of different polarized phenotypes of macrophages in the etiology and pathophysiology of endometriosis remains unknown. Here，we review the mechanism of macrophage M1/M2 phenotypic transition in heterotopia，explore the role of macrophages with different phenotypes in the endo⁃ metriosis⁃related microenvironment，and shed new scientific light on EMs'；therapeutic approaches.