OBJECTIVE： To provide suggestions for defining significant conflict of interest and in clinical drug trials formulating relevant management measures in China. METHODS： Through introducing the concept of interest conflict， the definition of significant interest conflict and management system of interest conflict in clinical drug trial were investigated （including management level， management object and management mode）. The definition and management recommendations were put forward for significant conflicts of interest in China. RESULTS & CONCLUSIONS： In clinical trials， interest conflicts maybe occurred in researcher and research institutions. United States Public Health Service， Association of American Medical Colleges， American New England Journal of Medicine and the Japanese Medical Association had defined the significant interests of researchers. The American management system could be divided into three levels， namely， the management policy of interest conflict was formulated by the Federation， the Association， the American clinical trial research institutions and the relevant academic journals. Japanese management system of interest conflict included government departments and associations. Management objects of American and Japanese different regulations and guidelines included main researchers and other main management objects. There were different management methods of conflicts of interests among researchers from different institutions in the United States， while the Japanese Medical Association provided a way to avoid the significant conflicts of interest of the researchers. On the basis of the definition and management of significant conflicts of interest in clinical trials between researchers and research institutions in the United States and Japan， it is suggested to define significant conflicts of interest based on national conditions and referring to other laws and regulations of other fields， avoidance management of significant conflicts of interest and establish a long-term multi-level interest conflict management system so as to reduce the risk of affecting the safety of the subjects and the reliability of the test results， and improve public trust on the industry of drug clinical trials.