Endocrine therapy is the basic treatment for patients with hormone receptor-positive breast cancer, which can significantly reduce the tumor recurrence and mortality. However, not all patients may benefit from endocrine therapy, so how to further improve the efficacy of endocrine therapy is of a great clinical significance. Carcinoma-associated fibroblasts (CAFs) are the major cellular component in the tumor stroma of breast cancer, possessing tumor-promoting characteristics distinct from those of normal fibroblasts. CAFs can change the microenvironment of the tumor cells and thereby, affect the efficacy of endocrine therapy. Recently, researches targeting CAFs have been gradually carried out, and also proved to be effective in improving the efficacy of endocrine therapy. The authors overview, in this article, the role of CAFs in endocrine therapy for breast cancer and how to improve the efficacy of endocrine therapy by targeting CAFs.