Abstract: Objective To investigate the efficacy and safety of tacrolimus in treatment of id-iopathic membranous nephropathy.Methods 41 patients with idiopathic membranous nephropathy (IMN)were randomly divided intotacrolimus group and CTX group .The tacrolimus group was treated with tacrolimus combined with glucocorticoid therapy while CTX group was given CTX combined with glucocorticoid therapy.The clinical indicators and efficiency,adverse reactions were observed before and after treatment.Results After 6 months,the levels of the 24 hour urinary protein,triglycerides,cholesterol in both groups decreased significantly (P <0.05),the serum al-bumin level was significantly higher (P < 0.05),but the improvement of these indicators in tacrolimus group were significantly better than that in the CTX group (P <0.05).The overall re-sponse rate in the tacrolimus group was significantly higher than that in the CTX group (90.48% vs 65.00%)(P <0.05).Conclusion Therapy of tacrolimus combined with glucocorticoids is an ef-fective and safe program in the treatment of IMN.