Mechanical ventilation is closely related to the occurrence and development of acute kidney injury (AKI). Its mechanism involves a comprehensive interaction of multiple factors, such as hemodynamic changes, release of inflammatory mediators, activation of neurohumoral systems, and blood gas disorders. New biomarkers, such as neutrophil gelatinase-associated lipocalin, tissue inhibitor of metalloproteinase-2, and insulin-like growth factor binding protein-7, along with machine learning models, aid in the early warning of AKI. This article reviewed the research progress on the epidemiology, pathophysiological mechanisms, early warning, and prevention and treatment strategies of mechanical ventilation-associated acute kidney injury (AKI), aiming to provide references for early identification, precise diagnosis, and standardized treatment of such patients.