OBJECTIVE：To provide reference for the clinical rational application and preventing the adverse reactions of hydroxyethyl starch （HES）. METHODS： The HES application of inpatients in a hospital in Jul. 2014 were retrospectively analyzed， the usage and dosage， indications， and the changes of renal functions and blood coagulation function before and after HES treatment were detected， and the application rationality was evaluated. RESULTS：The usage of HES in the hospital was hydroxyethyl starch 200/0.5 and Sodium chloride injection， which was the second generation of HES. In the 347 patients， 295 patients had monitored the renal functions before the HES treatment， the result was normal； and 21 patients had monitored the renal functions after HES treatment， the result was normal. Meanwhile， 326 patients had monitored the blood coagulation functions before and after HES treatment， the results were normal. HES was not used for the patient of severe sepsis， renal dysfunctions and coagulopathy in this hospital. CONCLUSIONS：The application of HES can induce renal damage and coagulation disorder， so relevant indicators should be closely monitored before and after treatment to prevent the incidence of adverse reactions； further more， clinicians should strictly handle indications， usage and dosage and precautions during the clinical application； in addition， it is suggested to replace the second generation of HES by the third generation， which is more safer.