Objective-To compare and analyze the differences between imipenem and meropenem in clinical application. Methods; The chemical structures,pharmacological effects,pharmacodynamics,pharmacokinetics,bacteriological efficacy,clinical efficacy,safety and pharmacoeconomics of imipenem and meropenem were analyzed and summarized through consultation of related literature. Results and Conclusion: Due to the differences of chemical structures,meropenem can be used alone,while imipenem has to be used in combination with cilastatin sodium. These two drugs exert antibacterial activity by binding to different sites of penicillin-binding protein. The peak concentration of imipenem in human blood is higher than that of meropenem. The maintenance time of effective blood concentration and the time to steady blood concentration in tissue of imipenem are longer than those of meropenem. The permeability of meropenem is better than that of imipenem and it can more readily pass through the blood-brain barrier. Corresponding to the treatment of gram-negative bacterial infection,meropenem is preferred, except in the case of infection by Acinetobacter baumannii and bacterial resistant Pseudomonas aeruginosa. With respect to gram-positive bacterial infection,imipenem is preferred for treatment. Due to the fact that hospital-acquired infection is a dominant factor, meropenem can achieve better clinical efficacy in the treatment of severe hospital-acquired infection. The rate of adverse drug reactions of these two drugs is quite similar,except that imipenem is more toxic to central nervous system than meropenem. In addition,these two drugs are relatively safer in clinical application. Pharmacoeconomics comparison further indicated that the cost-effectiveness of meropenem is relatively lower. © 2020 Publishing House of Pharmaceutical Care and Research. All rights reserved.