Macrophages can activate inflammatory responses after cerebral ischemic injury, aggravate tissue damage or alleviate inflammatory responses, and promote functional recovery of the body. This biphasic effect is related to its cell type. Exercise can affect macrophage phenotype transformation to exert neuroprotective effects, but this effect is closely related to the mode, intensity, and duration of exercise. This article systematically explores the regulatory mechanisms of different exercise regimens on macrophages by reviewing relevant literature in recent years, aiming to provide theoretical basis for clinical development of exercise regimens, prevention and treatment of cerebral ischemia-reperfusion injury mechanisms.