Test-time adaptation (TTA) adapts the pre-trained models during inference using unlabeled test data and has received a lot of research attention due to its potential practical value. Unfortunately, without any label supervision, existing TTA methods rely heavily on heuristic or empirical studies. Where to update the model always falls into suboptimal or brings more computational resource consumption. Meanwhile, there is still a significant performance gap between the TTA approaches and their supervised counterparts. Motivated by active learning, in this work, we propose the active test-time adaptation for semantic segmentation setup. Specifically, we introduce the human-in-the-loop pattern during the testing phase, which queries very few labels to facilitate predictions and model updates in an online manner. To do so, we propose a simple but effective ATASeg framework, which consists of two parts, i.e., model adapter and label annotator. Extensive experiments demonstrate that ATASeg bridges the performance gap between TTA methods and their supervised counterparts with only extremely few annotations, even one click for labeling surpasses known SOTA TTA methods by 2.6% average mIoU on ACDC benchmark. Empirical results imply that progress in either the model adapter or the label annotator will bring improvements to the ATASeg framework, giving it large research and reality potential.