Rheumatoid immune diseases (RID) are chronic autoimmune inflammatory diseases characterized by immune inflammatory cascade reactions, which are closely related to the occurrence and development of immune homeostasis imbalance. Macrophage efferocytosis plays a key regulatory role in delaying the progression of RID by clearing apoptotic cells, maintaining immune homeostasis, and promoting inflammation resolution. Recent studies have shown that active ingredients in traditional Chinese medicines such as Astragalus polysaccharide, Triptolide, Berberine, can upregulate the expression of efferocytosis-related proteins such as Mer tyrosine kinase, growth arrestspecific protein 6, scavenger receptor class A, and microtubule-associated protein 1 light chain 3 by regulating related signaling pathways, activating macrophage efferocytosis and regulating the immune microenvironment, inflammatory response, angiogenesis, epithelial mesenchymal transition, and endothelial-mesenchymal transition, delaying the progression of RID such as rheumatoid arthritis, systemic lupus erythematosus, and systemic sclerosis. This article summarizes the research result on the regulation of macrophage efferocytosis by active ingredients in Chinese medicine for the treatment of RID to provide new ideas for clinical application.