OBJECTIVE： To provide reference for pharmaceutical care of vancomycin-induced acute kidney injury （AKI） patients. METHODS： Clinical data of a AKI elderly patient admitted to our hospital in Sept. 2017 were analyzed retrospectively. Combined with professional knowledge of clinical pharmacy， anti-infective plan， AKI high-risk factor and treatment measures were analyzed. After the occurrence of ADR， relevant literatures were reviewed； the experience and lessons were summarized； the solutions were proposed， and the whole process of pharmaceutical care was implemented after elderly patient suffered from AKI due to the use of vancomycin. RESULTS & CONCLUSIONS： Pharmacists selected vancomycin anti-infective treatment empirically for the patient during treatment. The patient suffered from AKI. The clinical pharmacist analyzed that the patient was an elderly female with high risk factors （physiological impairment of renal function， exceeding recommended dose of vancomycin； overlong medication duration） and then occurrence of AKI. It was suggested to disable vancomycin immediately and use plasma replacement for treatment （replacing 1 300 mL plasma for 1.5 h）. The trough concentration of vancomycin declined rapidly on the second day （31.3→19.7 μg/mL）， and the renal function of the patient began to recover （Scr： 160.6→136.5 μmol/L； Ccr： 19.49→22.94 mL/min； GFR： 29.00→35.30 mL/min） so as to relieve AKI effectively. So， it is suggested that clinical use of vancomycin in elderly patients should be more cautious， risk factors， advantages， disadvantages and renal function also should be evaluated； drug dosage should be individually adjusted. Clinical pharmacists should strengthen the pharmaceutical care of patients using vancomycin to help avoid adverse events and ensure the safety and rationality of drug use.