Macrophages are a group of cells with diverse immune functions and high heterogeneity. Under the stimulation of different microenvironments, macrophages can be polarized into two subgroups:M1 and M2. There are significant differences in polarization phenotypes and function at different stages of myocardial fibrosis. That is, in the early stage of myocardial fibrosis, the proportion of M1 type increased to promote the progression of inflammation; in the later stage of myocardial fibrosis, the proportion of M2 type increased to alleviate myocardial fibrosis. The Notch signaling pathway can regulate macrophage polarization, which is related to the development of myocardial fibrosis, especially in cardiovascular diseases such as myocardial infarction and heart failure. Therefore, blocking the Notch signaling pathway is beneficial to regulating macrophage polarization, which is helpful to inhibit or reverse the process of myocardial fibrosis.