ABSTRACT Objective To review the effect of outer membrane vesicles (OMVs) of the periodontal pathogen Porphyromonas gingivalis ( P. gingivalis ) on macrophages during periodontitis development. Method Literature pertaining to P. gingivalis OMVs and macrophages was reviewed and discussed, with a focus on the immunomodulatory effects of P. gingivalis OMVs on macrophages. Results P. gingivalis OMVs affect the recognition, phagocytosis, polarization, and apoptosis functions of macrophages. However, information on their antigen‐presenting effect remains lacking, and further research is required for clinical applications. Conclusion P. gingivalis OMVs can influence the development of periodontitis through immune modulation of macrophages; however, further research is required to provide novel ideas for the prevention and treatment of periodontitis.