Background Acetylcholine, a kind of neurotransmitter released from vagus never ending, can act on α7 nicotinic acetylcholine receptors (α7nAChR) inhibit the release and production of inflammatory cytokines and recover the balance of inflammatory response. It has been recognized as cholinergic anti-inflammatory pathway (CAP). Object Objects of this review are to evaluate the mechanisms and effects of cholinergic anti-inflammatory pathway modulating inflammation. Content This article reviews the roles of CAP modulating inflammatory response in few diseases, which characterized acute and chronic inflammatory response, such as sepsis, ischemia-reperfusion injury and Crohn’s disease. Trend The activation of CAP is triggered not only by direct vagus never stimulation but also by the special α7nAChR agonists. As a kind of potential treatment, CAP may be applied widely in future clinic.