Aim To investigate the effects of IL-4 on ATP-binding cassette transporter A1 (ABCA1) expression and cholesterol efflux in human THP-1 macrophage-derived foam cells. Methods THP-1 macrophage-derived foam cells were treated with different concentrations of IL-4, different time, and liver X receptor α (LXRα) agonist T0901317. Semi quantitative RT-PCR and Western blot were used to detect the expressions of ABCA1, LXRα mRNA and protein respectively. Lipid accumulation in cells was observed by oil red O staining. Intracellular cholesterol efflux was detected by using liquid scintillation counting method. Total cholesterol, free cholesterol and cholesterol ester were determined by high performance liquid chromatography. Results IL-4 significantly decreased the expression of ABCA1 in a concentration- and time-dependent manner, and inhibited cholesterol efflux in the THP-1 macrophage-derived foam cells (P<0.05). T0901317 reversed the effect of IL-4 (P<0.05). Conclusions IL-4 decreases ABCA1 expression and inhibites cholesterol efflux in THP-1 macrophage-derived foam cells. LXRα activation can reverse the inhibitory effect of IL-4 on ABCA1.