Tumor-associated macrophages(TAM) are a current focus in the study of the tumor microenvironment. To achieve their functionally distinct roles, macrophages undergo phenotypic polarizations resulting in two major subgroups: M1 macrophages with pro-inflammatory and anti-tumor effects, and M2 macrophages with anti-inflammatory and pro-tumor effects. Among them, M2 polarization, which is the main manifestation of TAM, has been associated with poor prognosis in various cancers and has shown supportive properties for malignancies. Gastric carcinoma patients have a low early diagnosis rate, late disease stage, and poor prognosis, with biological behavior characteristics of easy recurrence and metastasis. Currently, drug resistance and toxic side effects significantly limit the application and effectiveness of gastric carcinoma treatment. Therefore, it is urgent to explore new therapeutic drugs or targets. We summarize in this review the recent progress in the studies of TAM in the occurrence, development and drug resistance of gastric carcinoma, providing new ideas for clinical treatment and prognosis analysis of patients with gastric carcinoma.