Abstract: The inflammatory reaction in ischemia and surrounding areas occurs throughout myocardial tissue repair and cardiac fibrosis after myocardial infarction. As an important component of inflammatory response, macrophages play an important role in the repair process after myocardial injury. Different subtypes of macrophages participate in all stages of myocardial infarction and play a variety of roles in phagocytosis of apoptotic cells, promotion of angiogenesis, and promotion of scar formation. Transplantation of mesenchymal stem cells (MSCs) has been widely used in the study of ischemic heart failure because of its immune regulation, paracrine myocardial protection and other effects. In recent years, it has been found that there is a close relationship between macrophages and MSCs in the treatment of ischemic heart disease. MSCs can promote myocardial repair by reducing the recruitment of proinflammatory macrophages at inflammatory sites and inducing macrophages to transform from M1 to M2. Macrophages can change the effect of myocardial repair by affecting the survival, proliferation, migration and immune regulation of MSCs. This article reviews the interaction between macrophages and MSCs and their role and application prospect in ischemic heart disease.