Abstract: Polymyxins are the last resort for the treatment of multidrug-resistant Gram-negative bacterial infections, but their neurotoxicity limits their clinical application. This paper discussed the molecular structure of polymyxins as well as the clinical manifestations, toxicity mechanisms, and prevention measures of their neurotoxicity, and it also pointed out the shortcomings of existing researches on neurotoxicity reports, and attempted to correlate the daily dose of polymyxins with neurotoxicity manifestations based on existing literatures, providing a reference for the rational use of polymyxins and the prevention of neurotoxicity in clinical practice.