Background　S (+)-ketamine is now widely used in Europe and America. Compared with racemic ketamine used in clinic in China, S(+)-ketamine has a better drug action in anesthesia and analgesic, less side effects in psyche, less secretion, and more rapid recovery from anesthesia.　Objective　The aim of this review was to describe the advances of clinical use of S(+)-ketamine and provide a practical guidance in clinical anesthesia in our country.　Content　It has been demonstrated that S(+)-ketamine plays a large role in such aspects as induction and maintenance of anesthesia, pain treatment, sedation analgesia in ICU, and pediatric anesthesia.　Trend　S (+)-ketamine will be more safely, effectively and widely utilized in clinic in future. Trend: S(+)-ketamine will be utilized clinically much more safely ,effectively and widely in future.