Considerable amounts of progress have been made to improve methods for treating RA within the past dozen of years. It is now clear that targeting macrophages in the development of RA is suitable for relieving symptoms or even for preventing them from developing. However, more research is to be done to promote the efficacy of current methods, as well as solving problems associated with frequent administration, sensitive reactions, and high doses. Treatment failures due to economical burdens are also problems to be solved. Macrophages are certainly linked with the progression of inflammation in the RA disease. In this article, we reviewed the role of macrophages and substances related to or secreted by them in the development of RA, and various treatments of RA targeting macrophages. Further research of macrophage behavior in inflamed joints with novel technologies may provide a better knowing of RA pathology, therefore helping develop RA therapies with less downsides.