Macrophages play an important role in the innate immune response to fungal pathogens. They express receptors which recognise a variety of fungal molecular patterns, many of which are conserved cell wall carbohydrates. We present an overview of the macrophage receptors shown to be involved in fungal recognition and binding, the various antifungal mechanisms utilised by these cells, and demonstrate strategies that fungal pathogens have evolved to escape these mechanisms. We also provide an overview of the current clinical anti-fungal agents, as well as strategies which are being developed to enhance the antimicrobial mechanisms of the macrophages themselves. Finally, we discuss fungal-derived carbohydrates and their potential use as immunomodulators.