Abstract: Metastasis is a crucial clinical event leading to mortality in patients with lung cancer. Effective screening, diagnosis, and treatment are still lacking for people with a high incidence of metastasis. The demonstrated significant effect of immunotherapy in the treatment of lung cancer indicates the potential of this strategy in the prevention and treatment of metastases. As an important part of innate immunity, macrophages are important in the occurrence and metastasis of tumors. The use of macrophages might improve tumor immunotherapy from the perspective of innate immunity. At different stages of tumorigenesis and development, macrophages are domesticated into different “states” by tumor cells in various organs of the body, which is beneficial for the development and metastasis of tumors. Therefore, targeted macrophage prevention and treatment of lung cancer metastasis has become a new strategy for tumor immunotherapy. The development of monoclonal antibodies and small molecule inhibitors targeting macrophage proliferation, recruitment, polarization, angiogenesis, and immunosuppression is an important aspect of research and development of new drugs against lung cancer metastasis.