Abstract: Oxidative stress is one of the main causes of many neurodegenerative diseases, which can lead to abnormal mitochondrial function, decrease the activity of antioxidant enzymes, and accelerate cell senescence and apoptosis. As a natural antioxidant, acetyl L-carnitine(ALC) has been proved to be related to the energy metabolism of mitochondria. It can inhibit the state of oxidative stress by scavenging excessive free radicals, increasing the activity of antioxidant enzymes, maintaining the normal operation of mitochondria and providing energy. And protect the body by regulating oxidative stress-related proteins and Keap-Nrf2/ARE, Wnt/β-catenin signal pathway. In clinical application, it has been used to study and treat Parkinson's disease, Alzheimer's disease, diabetes and other diseases. This article reviewed the latest research progress of ALC in antioxidation.