Abstract: Tacrolimus is a macrolide immunosuppressant.The action mechanisms of tacrolimus are similar to that of cyclosporine.Since the molecular weight is low,tacrolimus can penetrate the epidermal barrier.Topical tacrolimus shows favorable efficacy in the treatment of atopic dermatitis and other T cellmediated dermatoses,and has been regarded as a new treatment alternative for skin diseases.The safety of long-term use of tacrolimus has attracted more and more attention because of its severe immunosuppressive effects and some potential problems of systemic absorption.Data are limited on the systemic evaluation of adverse reactions of topical tacrolimus.The authors review recent reports on side effects of topical tacrolimus at home and abroad,in hope to promote its proper use.