Postoperative acute kidney injury (AKI) is a group of complex clinical syndromes, characterized by an abrupt de⁃ cline of renal function, and about 1.7 million people die from AKI every year worldwide. Postoperative AKI after joint replacement is quite common, as patients are often accompanied by postural changes, heavy bleeding and severe stress response during operation. AKI is associated with increased resource utilization, mortality and risk of death. At present, there are still controversies about the risk fac⁃ tors of AKI, and the relevant mechanisms are not fully understood. This article reviews the epidemiology and diagnostic criteria of AKI to deepen clinicians' understanding towards this common complication; based on recent international literatures, this article summariz⁃ es the perioperative high⁃risk factors and the current prevention and treatment of AKI after joint replacement, so as to improve clinical management and consequently reduce the occurrence of postoperative AKI.