Immunotherapy holds promise for thyroid cancer (TC) treatment. In the context of our previous findings that artesunate (ART) could inhibit the migration and invasion of TC cells through phosphoinositide 3-kinase/protein kinase B (PI3K/Akt), this study was engineered to investigate whether ART regulates the tumor microenvironment in TC. THP-1 cells were differentiated into M0 macrophages by the induction of 100 ng/mL of phorbol 12-myristate 13-acetate and transfected as needed. M0 macrophages were treated with different concentrations of ART (10 and 20 μM) for 24 h. The co-culture of macrophages and TC cells was conducted. Flow cytometry and enzyme-linked immunosorbent assay were used to identify M2 macrophages. The viability, migration, and invasion of TC cells were detected by cell counting kit-8, wound healing, and transwell assays. The mRNA or protein expressions of examined genes were measured by quantitative real-time polymerase chain reaction or Western blot. In co-cultured macrophages, protein expressions of CD206, CD163, and Arginase-1, as well as the secretion of IL-10 and CCL18, were promoted, but phosphatase and tensin homolog (PTEN) mRNA expression was inhibited, which were reversed by different concentrations of ART. In the co-culture system, 20 μM of ART downregulated mRNA expressions of CD206, CD163, and Arginase-1 in macrophages and diminished viability, migration, invasion, as well as ratios of p-PI3K/PI3K and p-Akt/Akt in TC cells, which were offset by PTEN deletion in macrophages. Collectively, ART suppresses the migration and invasion of TC cells via inhibiting the PI3K/Akt pathway by PTEN upregulation-blocked M2 polarization of tumor-associated macrophages.