OBJECTIVE: To compare the effects of different doses of ramipril on blood pressure and renal function of early diabetic nephropathy patients. METHODS: A total of 108 patients with early diabetic nephropathy selected from our hospital during May 2014-Dec. 2015 as research objects were divided into group A, B, C, with 36 cases in each group. All groups were given Ramipril tablets, 5 mg for group A, 2.5 mg for group B, 1.25 mg for group C, qd, for 8 weeks. Blood pressure (SBP, DBP) and renal function indexes (24 h urine protein, β2-microglobulin, UAE) were compared among 3 groups before and after treatment. The occurrence of ADR was also recorded in 3 groups. RESULTS: Before treatment, there was no statistical significance in blood pressure or renal function indexes among 3 groups (P>0.05). After treatment, blood pressures 24 h urine protein, β2-microglobulin and UAE of 3 groups were decreased significantly; those indexes of group A were significantly lower than group B and C, with statistical significance (P<0.05). There was no statistical significance in each index between group B and C (P>0.05). Both hypotension and hypoglycemia occurred in 3 groups during treatment, but were recovered after stopping treatment. CONCLUSIONS: High dose of ramipril (5 mg,qd) shows good effects on early diabetic nephropathy and reduces urinary protein excretion, but doesn’t affect its safety.