The chapter discusses the role of macrophages in cardiovascular diseases, focusing on their molecular mechanisms and therapeutic targets. Macrophages, as key players in the innate immune system, play a crucial role in both the inflammatory response and tissue repair following cardiovascular injury. Their diverse phenotypes and phenotypic alterations are associated with various types and severities of cardiovascular diseases, including coronary heart disease, valvular disease, myocarditis, cardiomyopathy, heart failure, atherosclerosis, and aneurysm. Recent advancements in single-cell sequencing technologies have provided new insights into macrophage heterogeneity, cell-cell interactions, and downstream mechanisms, highlighting the importance of understanding macrophage regulatory mechanisms in specific diseases. The chapter also emphasizes the significance of myocardial fibrosis, a common characteristic in many cardiac diseases, and the need to investigate macrophage-mediated mechanisms and potential therapeutic targets. It reviews the diverse phenotypic and functional plasticity of macrophages in cardiovascular diseases, particularly in the context of inflammation and fibrosis in cardiac diseases such as myocardial infarction, pressure overload, myocarditis, dilated cardiomyopathy, diabetic cardiomyopathy, and cardiac aging. Additionally, it discusses the relationship between inflammation and vascular injury in vascular diseases like atherosclerosis and aneurysms. Finally, the chapter highlights preclinical and clinical macrophage-targeting strategies and their translational implications, providing a comprehensive overview of the current understanding and future directions in macrophage research for cardiovascular diseases.The chapter discusses the role of macrophages in cardiovascular diseases, focusing on their molecular mechanisms and therapeutic targets. Macrophages, as key players in the innate immune system, play a crucial role in both the inflammatory response and tissue repair following cardiovascular injury. Their diverse phenotypes and phenotypic alterations are associated with various types and severities of cardiovascular diseases, including coronary heart disease, valvular disease, myocarditis, cardiomyopathy, heart failure, atherosclerosis, and aneurysm. Recent advancements in single-cell sequencing technologies have provided new insights into macrophage heterogeneity, cell-cell interactions, and downstream mechanisms, highlighting the importance of understanding macrophage regulatory mechanisms in specific diseases. The chapter also emphasizes the significance of myocardial fibrosis, a common characteristic in many cardiac diseases, and the need to investigate macrophage-mediated mechanisms and potential therapeutic targets. It reviews the diverse phenotypic and functional plasticity of macrophages in cardiovascular diseases, particularly in the context of inflammation and fibrosis in cardiac diseases such as myocardial infarction, pressure overload, myocarditis, dilated cardiomyopathy, diabetic cardiomyopathy, and cardiac aging. Additionally, it discusses the relationship between inflammation and vascular injury in vascular diseases like atherosclerosis and aneurysms. Finally, the chapter highlights preclinical and clinical macrophage-targeting strategies and their translational implications, providing a comprehensive overview of the current understanding and future directions in macrophage research for cardiovascular diseases.