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Significance: The aberrant inflammation during wound healing results in pathological scarring, such as hypertrophic scars and keloids. This adversely affects the quality of life of patients due to the disfiguring appearance as well as the symptoms of itch and pain. This review summarizes the up-to-date knowledge of the immunopathogenesis and treatment options for pathological scars.With the advent of new technologies, combined with in vitro and in vivo wound models, several inflammatory cells have been shown to have both direct or indirect effects on both wound healing and pathological scarring.Expansion of pro-fibrotic immune cells such as M2 macrophages, dendritic cells, mast cells, and Th2 cells leads to fibroblast transition to myofibroblasts via TGF-β1 signaling pathway. Appropriate management of such inflammatory responses during wound healing remains a critical issue during clinical practice.Regulating inflammation response during wound healing may be a potential therapeutic option for avoiding or reducing pathological scars.