Tumor-associated macrophages (TAMs) are a critical component of the tumor microenvironment, playing dual roles in tumor progression. They can be categorized into two functionally contrasting subtypes: classical activated M1 macrophages, which exert anti-tumor functions, and alternatively activated M2 macrophages, which promote tumor growth, invasion, and metastasis. The plasticity of TAMs allows them to switch between these phenotypes based on the tumor microenvironment. Recent studies have highlighted the importance of TAMs in cancer immunosuppression and their potential as therapeutic targets. This review discusses the origins and types of TAMs, their interactions with the tumor microenvironment, and emerging strategies for targeting TAMs in cancer treatment. Key factors regulating TAM functions include tumor cell-derived soluble molecules, metabolic alterations, and other immune cells. Targeting TAMs involves limiting monocyte recruitment, inhibiting TAM activation, reprogramming TAMs into anti-tumor activity, and targeting specific TAM markers. These strategies show promising results in pre-clinical and clinical studies, making TAM-targeting therapy a promising approach for cancer treatment.Tumor-associated macrophages (TAMs) are a critical component of the tumor microenvironment, playing dual roles in tumor progression. They can be categorized into two functionally contrasting subtypes: classical activated M1 macrophages, which exert anti-tumor functions, and alternatively activated M2 macrophages, which promote tumor growth, invasion, and metastasis. The plasticity of TAMs allows them to switch between these phenotypes based on the tumor microenvironment. Recent studies have highlighted the importance of TAMs in cancer immunosuppression and their potential as therapeutic targets. This review discusses the origins and types of TAMs, their interactions with the tumor microenvironment, and emerging strategies for targeting TAMs in cancer treatment. Key factors regulating TAM functions include tumor cell-derived soluble molecules, metabolic alterations, and other immune cells. Targeting TAMs involves limiting monocyte recruitment, inhibiting TAM activation, reprogramming TAMs into anti-tumor activity, and targeting specific TAM markers. These strategies show promising results in pre-clinical and clinical studies, making TAM-targeting therapy a promising approach for cancer treatment.