Pancreatic cancer is a kind of highly aggressive malignant tumor of the digestive system. The treatment of local tumors is mainly surgical resection, but the indications are too harsh. For advanced pancreatic cancer, chemotherapy is the standard treatment, but patients have severe side effects and develop drug resistance. Tumor-associated macrophages in the tumor microenvironment of pancreatic cancer are the most abundant immune cells and play a very important role in tumor development and chemoresistance. Antitumor-associated macrophage therapy has shown some therapeutic potential. Therefore, this article reviews the mechanism of tumor-associated macrophages in pancreatic cancer and the progress of tumor-associated macrophage targeted therapy.