Anti-neutrophil cytoplasmic antibody (ANCA) associated vasculitis (AAV) constitues a group of autoimmune diseases with poor prognosis. Inflammation and fibrinoid necrosis of the small vessels are the pathological features of the disease, and many organs and systems can be involved. Monocyte-macrophages are important to innate immune system. Monocyte-macrophage can respond rapidly to inflammation and participate in the progression of AAV. Recently, the role of monocyte-macrophage in AAV has been studied with great detail. This article reviews recent research progress of monocyte-macrophage in AAV so as to further understand the disease.