Polysaccharides are among the most important members of the biopolymer family. They are natural macromolecules composed of monosaccharides. To date, more than 300 kinds of natural polysaccharide compounds have been identified. They are present in plants, animals, and microorganisms, and they engage in a variety of physiological functions. In the 1950s, due to the discovery of their immunoregulatory and anti-tumor activities, polysaccharides became a popular topic of research in pharmacology, especially in immunopharmacology. Plants are an important source of natural polysaccharides. Pharmacological and clinical studies have shown that plant polysaccharides have many functions, such as immune regulation, anti-tumor activity, anti-inflammatory activity, anti-viral functions, anti-radiation functions, and a hypoglycaemic effect. The immunomodulatory effects of plant polysaccharides have received much attention. Polysaccharides with these effects are also referred to as biological response modifiers (BRMs), and research on them is one of the most active areas of polysaccharide research. Thus, we summarize immunomodulatory effects of botanical polysaccharides isolated from different species of plants on the macrophage. The primary effect of botanical polysaccharides is to enhance and/or activate macrophage immune responses, including increasing reactive oxygen species (ROS) production, and enhancing secretion of cytokines and chemokines. Therefore, it is believed that botanical polysaccharides have significant therapeutic potential, and represent a new method for discovery and development of novel immunomodulatory medicine.