We examined the effect of mechanical fluid flow and surfactant on macrophage aggregation as the indication of macrophage activation. Mechanical fluid flow enhanced aggregation in phorbol myristate acetate (PMA)-treated human myeloid leukemic cell lines (HL-60 cells), but had no effect on differentiation of PMA-treated HL-60 cells. Surfactant-TA (an artificial surfactant) inhibited fluid flow–induced aggregation, but had no effect on differentiation of PMA-treated HL-60 cells. Human alveolar macrophages spontaneously formed small aggregates without stimulation. This aggregation was enhanced by fluid flow and inhibited by surfactant-TA. Taken together, these data suggest that macrophage activation is affected by fluid flow and surfactants.