Macrophage polarization plays a critical role in inflammation during infectious diseases, with M1-like and M2-like macrophages representing two extremes of a continuum. While M1-like macrophages are pro-inflammatory and involved in pathogen elimination, M2-like macrophages are anti-inflammatory and involved in tissue repair. This review discusses the biology of macrophage polarization, its role in inflammation and resolution, and its relevance in infectious and neglected diseases. It highlights the importance of understanding the continuum of macrophage polarization and its determinants for developing therapeutic strategies. The review also explores the role of macrophage polarization in various diseases, including leishmaniasis, and emphasizes the need for a nuanced understanding of macrophage function in human infections. The study shows that macrophage polarization is dynamic and influenced by environmental factors, with M1-like and M2-like macrophages often coexisting in complex inflammatory environments. The review underscores the importance of balancing macrophage polarization to effectively combat infections and promote tissue repair.Macrophage polarization plays a critical role in inflammation during infectious diseases, with M1-like and M2-like macrophages representing two extremes of a continuum. While M1-like macrophages are pro-inflammatory and involved in pathogen elimination, M2-like macrophages are anti-inflammatory and involved in tissue repair. This review discusses the biology of macrophage polarization, its role in inflammation and resolution, and its relevance in infectious and neglected diseases. It highlights the importance of understanding the continuum of macrophage polarization and its determinants for developing therapeutic strategies. The review also explores the role of macrophage polarization in various diseases, including leishmaniasis, and emphasizes the need for a nuanced understanding of macrophage function in human infections. The study shows that macrophage polarization is dynamic and influenced by environmental factors, with M1-like and M2-like macrophages often coexisting in complex inflammatory environments. The review underscores the importance of balancing macrophage polarization to effectively combat infections and promote tissue repair.