The accumulation of a large number of apoptotic and necrotic cells in atherosclerotic plaques is the main cause of plaque enlargement, necrotic core formation and plaque rupture. Apoptotic cells are engulfed and cleared quickly by macrophage and other phagocytes mediated efferocytosis in physiological state. However, recent studies have shown that the clearance rate of apoptotic cells in plaque is far lower than that in physiological state, and its mechanism is closely related to macrophage mediated efferocytosis dysfunction. This review summarizes the research progress of macrophage mediated efferocytosis and its functional defects in atherosclerosis, and hopes to provide theoretical and experimental basis for prevention and treatment of atherosclerotic cardiovascular disease.