Bio-inspired macrostructure array (MAA, size: submillimeter to millimeter scale) materials with special wettability (MAAMs-SW) have attracted considerable attention due to their outstanding performance in many fields, such as oil repellency, liquid/droplet manipulation, anti-icing, heat transfer, water collection, and oil−water separation. In this review, we mainly focus on recent developments in the theory, design, fabrication, and application of bio-inspired MAAMs-SW. First, we briefly introduce the basic theory of special wettability. Afterwards, we discuss representative structures and corresponding functions of some biological surfaces. Then, we summarize fabrication methods of special wetting MAAs from the three categories of additive manufacturing, subtractive manufacturing, and formative manufacturing, including 3D printing, laser etching, wire electrical discharge machining, micro-mechanical cutting machining, electrochemical machining, template method, and imprinting method. In addition, we demonstrate the applications of these MAAMs-SW. Lastly, the challenges and directions of future research on bio-inspired MAAMs-SW are briefly addressed.