Macrophages are important immune cells in innate immunity, with significant heterogeneity and polarization. It can polarize into various phenotypes (mainly M1 and M2) under the stimulation of various factors in the microenvironment, thus exerting different roles and functions. It plays an important role in the pathophysiological mechanism of renal ischemia-reperfusion injury (RIRI). Excessive immune response will inevitably lead to tissue damage. M1 macrophages are pro-inflammatory cells, which are involved in the clearance of pathogens. M2-type macrophages have anti-inflammatory effects and participate in the repair and remodeling of renal tissue after RIRI. The balance between macrophage phenotypes is important for the outcome and treatment of RIRI. Reason from the macrophage polarization Angle, the macrophages in RIRI pathophysiologic mechanism and the latest treatments, designed to further study the function of macrophage polarization in RIRI for reference, to adjust the macrophage polarization to improve RIRI treatment strategies.