Abstract: OBJECTIVE To provide reference for the safe and effective use of voriconazole by analyzing the medical record information and clinical treatment effect of voriconazole adverse reactions in Taizhou Central Hospital. METHODS The blood concentration monitoring results of voriconazole in 280 patients with invasive fungal disease in Taizhou Central Hospital from December 2015 to December 2020 were retrospectively analyzed. Naranjo's quantitative score scale was used to determine the correlation of adverse reactions and NCI-CTCAE standard was used to evaluate the severity of adverse reactions. Meanwhile, the main clinical intervention measures and outcomes were summarized. RESULTS 52 patients had suffered from adverse reactions, the median trough concentration was 3.80(1.80, 5.93)μg·mL^-1, and no life-threatening adverse reactions were observed. Hepatotoxicity, central nervous system toxicity and visual impairment were the most common adverse reactions, and the trough concentration was (5.17±3.39), (4.45±3.74), and (4.21±3.01)μg·mL^-1, respectively. The incidence of adverse reactions was not related to age, gender, underlying disease and infection sites, valley concentrations in those with adverse reactions were higher than in none. Meanwhile, the concentration of patients suffered from hepatotoxicity was higher than without adverse reactions(P<0.05). The main treatment methods of the adverse reactions were withdrawn voriconazole, symptomatic treatment and reduction 50% dosage, according to the NCI grade and trough concentration. Finally, 51 patients had good prognosis. CONCLUSION Patients with high trough concentration are more likely to have adverse reactions, and the incidence of voriconazole adverse reactions is not affected by age, gender, underlying disease and infection site. And to ensure the safety of medication, the upper limit of trough concentration could be set to 4 μg·mL^-1. The trough concentration and NCI grade should be taken into account when dealing with the adverse reactions.