ABSTRACT Macrophage foam cell formation is the critical step in the development of atherosclerosis. Berberine, a botanical alkaloid, has been suggested to regulate lipid homeostasis by reducing serum cholesterol and triglyceride levels and to improve glucose metabolism. This study investigated the role of Berberine on lipid metabolism in macrophages. In THP-1-derived macrophages, Berberine suppressed lipid accumulation induced by oxidized-low density lipoprotein (ox-LDL). Berberine augmented the mRNA and protein expression of ATP-binding membrane cassette transport protein A1 (ABCA1) but did not alter the protein levels of ATP-binding membrane cassette transport protein G1 (ABCG1)、scavenger receptor B1 (SR-B1)、scavenger receptor A (SR-A) and clusters of differentiation 36 (CD36). Moreover, ABCA1 antibody or inhibitor abrogated the suppressive effect of Berberine on lipid accumulation. Finally, western blot analysis and confocal microscopy revealed that Berberine enhanced the nuclear translocation of liver X receptor-a but not its protein expression. These data suggest that Berberine inhibits the formation of foam cells by enhancing cholesterol efflux and could be effective for treatment of atherosclerosis.