目的　避免急性特发性角膜内皮炎误诊误治。方法　对 4例特发性角膜内皮炎的临床表现、治疗方法和误诊原因进行总结分析。结果　 4例中 3例因未及时诊断治疗而引起不同程度的视力下降 ,甚至失明。结论　引起误诊的主要原因是对本病缺乏认识。建议提高临床医生对本病的认识 ,及时诊断治疗 Objective To avoid misdiagnosis and mistreatment of acute idiopathic corneal endodermatitis. Methods The clinical manifestations, treatment and misdiagnosis of 4 cases of idiopathic corneal endothelitis were analyzed. Results In 4 cases, 3 cases failed to make timely diagnosis and treatment, which caused different degrees of vision loss and even blindness. Conclusion The main reason of misdiagnosis is the lack of understanding of this disease. It is recommended to improve the clinician’s understanding of the disease, timely diagnosis and treatment