Atherosclerosis is the main pathological basis for the occurrence and development of cardiovascular and cerebrovascular diseases. Macrophage efferocytosis deficiency exists in the formation of atherosclerosis. Defective efferocytosis leads to the accumulation of uncleared apoptotic cells and secondary necrosis, leading to characteristic formation of necrotic core and plaque instability in atherosclerosis. The complete process of efferocytosis includes recognition(“find me”)stage, phagocytosis(“eat me”)stage, and the post-processing reaction (digestion) stage. It has been reported that miRNA is involved in the regulation of key signal transduction and lipid homeostasis in atherosclerotic efferocytosis. This paper discussed the important role of efferocytosis in the process of atherosclerosis and the influence of efferocytosis defect on atherosclerosis. This review focuses on the regulatory effects of “eat me”and “don't eat me”signals of efferocytosis in the overall inflammation of atherosclerosis, and meanwhile the regulation of miRNA on lipid metabolism and inflammation regression in atherosclerosis, and the fine tuning of miRNA targeting macrophage efferocytosis in the process of atherosclerosis.