OBJECTIVE： To investigate the clinical manifestations and pathway of ceftriaxone-induced obstructive and renal acute kidney injury （AKI）. METHODS： Two cases of ceftriaxone-induced AKI （one case of obstructive AKI and one case of renal AKI） in the First Affiliated Hospital of Xi’an Jiaotong University （called “our hospital” for short） were reported. Retrieved from PubMed， CNKI， Wanfang database， VIP and other databases during Jan. 1997-Dec. 2017， related literatures about ceftriaxone-induced obstructive and renal AKI were collected； occurrence time and clinical manifestations of them were analyzed. Based on above results， clinical pathway was established for ceftriaxone-induced obstructive and renal AKI. RESULTS： Renal function of patients with obstructive and renal AKI， which were induced by intravenous drip of ceftriaxone for “throat pain”/“intermittent lower abdominal pain”， renal function returned to normal after treatmenting 6 weeks and 6 months in our hospital respectively. A total of 270 cases were retrieved； ceftriaxone-induced obstructive and renal AKI mainly occurred within 7 d of treatment， and male was more than female. There were 252 cases of obstructive AKI （93.33％）， mainly manifesting as lumbar abdominal pain， oliguria or urinuria， hydronephrosis or ureteral dilatation； renal function could return to normal if diagnosing and treating timely， with cure rate of 100％. There were 18 cases of renal AKI （6.67％）， manifesting as rash， hematuria， proteinuria and edema； renal function was not easy to recover； clinical prognosis was poor with cure rate of 27.78％. According to the difference of clinical manifestations， occurrence charateristic， clinical outcome， the clinical pathway was established， that is， renal function can be restored after removal of obstructive AKI obstruction， renal biopsy should be performed in patients with no contraindication of renal AKI to determine the pathological type， and glucocorticoid therapy or combined immunosuppressive therapy should be considered in patients with no remission of renal function after symptomatic treatment. CONCLUSIONS： The clinical pathway for ceftriaxone-induced obstructive and renal AKI is preliminarily established so as to provide reference for rapid identification and diagnosis of clinicians.