Objective To investigate the effects of prostaglandin El (PGE1) on the progression of aristolochic acid nephropathy AAN).Methods Twenty-four patients diagnosed as AAN with serum creatinine (Scr) between 1.5 mg/dL and 4 mg/dL during September 2001 to August 2003 were randomly divided into 2 groups. All patients had ingested long dan xie gan wan containing aristolochic acid (0.219 mg/g) for at least 3 months. Twelve patients were injected with Alprostadil (10 μg/d for 10days in one month, summing up to 6 months). Except for PGE1, the other therapy was same in both groups. Renal function was assessed using reciprocal serum creatinine levels (1/Scr).Results The level of Scr and serum hemoglobin (Hgb) was similar in both groups prior to therapy. During follow-up,1/Scr levels in PGE1 group were significantly higher than control group (P ＜ 0.01), and Hgb levels in PGE1 group were significantly increased compared with control (P ＜ 0.05).Conclusion PGE1 can slow the progression of renal failure and increase Hgb level of AAN patient.