Background　Remifentanil has been widely applied in the clinic because of its excellent pharmacological properties. However， some adverse effects usually occur perioperatively and put threats to the patients， which cannot be ignored by the anesthesiologist.　Objective　To discuss the adverse effects of remifentanil occurred perioperatively.　Content　This paper reviews the etiology and prevention of remifentanil?蛳induced bucking， respiratory depression， bradycardia， muscle rigidity and hyperalgesia after withdrawal from remifentanil.　Trend　To fully understand and promptly treat remifentanil?蛳induced adverse effects is helpful for the safe use of remifentanil in the clinic.