OBJECTIVE： To explore how to avoid the risks of immunosuppressant off-label uses. METHODS： The situation of immunosuppressant off-label uses was introduced in our hospital， mainly including over indication drug use， over age drug use， over drug combination. Related reference were checked to analyze the effectiveness， safety and reasonability. RESULTS&CONCLUSIONS： Immunosuppressant off-label use needs scientific and reasonable basis. In consideration of patients’ interests and medical necessity， off-label drug use could be carried out appropriately and reasonably in situations where patients are aware of the risks and consent. However， laboratory index， like blood concentration， and adverse reactions should be monitored at regular intervals， therapeutic regimens are supposed to be adjusted based on clinical manifestation.