Abstract: Oral cancer is a common inflammation-associated malignant tumor of the head and neck. In recent years, the role of the tumor microenvironment in the progression of oral cancer has received increasing attention. In the microenvironment of solid tumors, including oral cancer, tumor-associated macrophages (TAMs) are among the most common type of immune cell and are closely associated with the poor prognosis of more than 80% of human malignant tumors. An increasing body of evidence indicates that TAMs play important roles in the occurrence and progression of oral cancer. On the basis of the most recent research progress, both domestic and international, we systematically reviewed the phenotypic characteristics, clinicopathological correlations, and molecular regulatory mechanisms of TAMs in the microenvironment of oral squamous cell carcinoma. In particular, we focus on the key signaling pathways promoting tumorigenesis and development and immune escape mechanisms, with the aim of constructing a systematic theoretical framework for developing therapeutic strategies targeting TAMs and providing a scientific basis for clinical translational research.