Traditional Chinese medicine Alisma orientalis is widely used in clinical diseases, and has many functions such as anti-atherosclerosis, treatment of nephritis, diuresis, and inhibition of stones. In vitro studies have shown that Alisma orientalis extract has nephrotoxic effects on renal tubular epithelial cells. It is safe in animal experiments, and no significant liver and kidney toxicities have been reported in clinical practice. Based on a large number of related studies on Alisma orientalis, this paper analyzed the toxic side effects of Alisma orientalis and its possible doses, processing, compatibility, drug origin, individual patient differences, etc. And the pharmacodynamics, clinical application, efficacy, and safety of Alisma orientalis were also reviewed, so as to better guide clinical medications, especially in the field of nephrology.