Background Remifentanil is a new type of μ opioid receptor agonist， which can effectively restrain the cardiovascular stress response. With the increasing clinical application， the reports that remifentanil causes bradycardia and hypotension are increasing.　Objective　This review on the mechanism of remifentanil on cardiovascular would provide theory support for further clinical and basic research.　Content　This review is to illustrate the mechanism of bradycardia and hypotension caused by remifentanil from five aspects.　Trend　So far， the mechanism of remifentanil causes bradycardia and hypotension is not entirely clear， and electrophysiology could be applied for further research.