diff --git a/clang-tools-extra/clangd/index/Ref.h b/clang-tools-extra/clangd/index/Ref.h
--- a/clang-tools-extra/clangd/index/Ref.h
+++ b/clang-tools-extra/clangd/index/Ref.h
@@ -30,7 +30,12 @@
   Declaration = static_cast<uint8_t>(index::SymbolRole::Declaration),
   Definition = static_cast<uint8_t>(index::SymbolRole::Definition),
   Reference = static_cast<uint8_t>(index::SymbolRole::Reference),
-  All = Declaration | Definition | Reference,
+  // This corresponds to index::SymbolRole::Implicit. In order to save memory
+  // and keep RefKind occupying 1 byte, the original value is modified to the
+  // one below.
+  Implicit = 1 << 3,
+  All = Declaration | Definition | Reference | Implicit,
+  NotImplicit = Declaration | Definition | Reference,
 };
 
 inline RefKind operator|(RefKind L, RefKind R) {
diff --git a/clang-tools-extra/clangd/index/SymbolCollector.cpp b/clang-tools-extra/clangd/index/SymbolCollector.cpp
--- a/clang-tools-extra/clangd/index/SymbolCollector.cpp
+++ b/clang-tools-extra/clangd/index/SymbolCollector.cpp
@@ -180,7 +180,14 @@
 }
 
 RefKind toRefKind(index::SymbolRoleSet Roles) {
-  return static_cast<RefKind>(static_cast<unsigned>(RefKind::All) & Roles);
+  // Because RefKind::Implicit != index::SymbolRole::Implicit because due to the
+  // memory considerations, all flags except "Implicit" should be set
+  // independently.
+  auto Result =
+      static_cast<RefKind>(static_cast<unsigned>(RefKind::NotImplicit) & Roles);
+  if (Roles & static_cast<unsigned>(index::SymbolRole::Implicit))
+    Result |= RefKind::Implicit;
+  return Result;
 }
 
 bool shouldIndexRelation(const index::SymbolRelation &R) {
@@ -291,7 +298,17 @@
   // occurrence inside the base-specifier.
   processRelations(*ND, *ID, Relations);
 
-  bool CollectRef = static_cast<unsigned>(Opts.RefFilter) & Roles;
+  // Check if the referenced symbol is spelled exactly the same way the
+  // corresponding NamedDecl is. If it isn't, mark this reference as implicit.
+  // An example of implicit references would be a macro expansion.
+  llvm::SmallString<16> Buffer;
+  const auto Spelling =
+      Lexer::getSpelling(Loc, Buffer, SM, ASTCtx->getLangOpts());
+  DeclarationName Name = ND->getDeclName();
+  if (Name.isIdentifier() && Name.getAsString() != Spelling)
+    Roles |= static_cast<uint32_t>(index::SymbolRole::Implicit);
+
+  bool CollectRef = static_cast<unsigned>(Opts.RefFilter & toRefKind(Roles));
   bool IsOnlyRef =
       !(Roles & (static_cast<unsigned>(index::SymbolRole::Declaration) |
                  static_cast<unsigned>(index::SymbolRole::Definition)));
diff --git a/clang-tools-extra/clangd/refactor/Rename.cpp b/clang-tools-extra/clangd/refactor/Rename.cpp
--- a/clang-tools-extra/clangd/refactor/Rename.cpp
+++ b/clang-tools-extra/clangd/refactor/Rename.cpp
@@ -296,6 +296,8 @@
   bool HasMore = Index.refs(RQuest, [&](const Ref &R) {
     if (AffectedFiles.size() > MaxLimitFiles)
       return;
+    if (static_cast<unsigned>(R.Kind & RefKind::Implicit))
+      return;
     if (auto RefFilePath = filePath(R.Location, /*HintFilePath=*/MainFile)) {
       if (*RefFilePath != MainFile)
         AffectedFiles[*RefFilePath].push_back(toRange(R.Location));
diff --git a/clang-tools-extra/clangd/unittests/RenameTests.cpp b/clang-tools-extra/clangd/unittests/RenameTests.cpp
--- a/clang-tools-extra/clangd/unittests/RenameTests.cpp
+++ b/clang-tools-extra/clangd/unittests/RenameTests.cpp
@@ -837,7 +837,7 @@
       {
           // variables.
           R"cpp(
-      static const int [[VA^R]] = 123;
+        static const int [[VA^R]] = 123;
       )cpp",
           R"cpp(
         #include "foo.h"
@@ -868,6 +868,22 @@
         }
       )cpp",
       },
+      {
+          // Implicit references in macro expansions.
+          R"cpp(
+        class [[Fo^o]] {};
+        #define FooFoo Foo
+        #define FOO Foo
+      )cpp",
+          R"cpp(
+        #include "foo.h"
+        void bar() {
+          [[Foo]] x;
+          FOO y;
+          FooFoo z;
+        }
+      )cpp",
+      },
   };
 
   for (const auto& T : Cases) {