Abstract: Trimethylamin N-oxide (TMAO) is the oxygenated product of trimethylamine,which mostly derives from the bacterial metabolism of choline and Lcarnitine and then is absorbed into the bloodstream and rapidly oxidized by flavincontaining monooxygense3 in liver.In recent years,TMAO attracts attention for its positive relationship with high risk for cardiovascular events.Amounts of clinical studies show that TMAO is one of the biomarkers for many disorders,such as heart failure,renal failure,diabetes,obesity,thrombosis,cancer and atherosclerosis.The advancement of interaction between TMAO and chronic kidney disease (CKD) and its adverse cardiovascular events,and the effect of targeting therapy of trimethylamine formation inhibitor in treating CKD were reviewed in this article.