Abstract: OBJECTIVE To analyze the serious adverse reactions caused by telbivudine to provide a reference for clinical use of telbivudine. METHODS Search the database include CNKI, Wan Fang and VIP information, collect the serious adverse reactions caused by telbivudine, analyze the statistics. RESULTS Collected 1 012 cases of adverse reactions of telbivudine, 42 cases of them were serious. The general information, combined medication, clinical symptoms, laboratory tests results, treatments, and prognosis in patients were analyzed. There were 41 male cases, in which 5 cases of death caused by rhabdomyolysis. CONCLUSION It should be strengthened the monitoring of the clinical use of telbivudine, avoid serious adverse reactions which is high mortality.