Prostaglandin E1 (PGE1), a major component of prostaglandin injection, is a potent physiologically active substance with a wide range of physiological and pharmacological effects. It can be used to treat diabetic nephropathy (DN) through various mechnisims, such as inhibiting platelet aggregation, inhibiting inflammatory reaction and dilating renal vessels. It is effective and safe. The current study evidenced that alprostadil injection can be used alone, in sequential treatment or with other drugs. Any of these can reduce 24 h urinary proteinuria, serum creatinine, urinary albumin, blood urea nitrogen and other related indicators of DN, thus effectively improve renal function, and delay the progression of kidney disease, and it is more effective with early treatment. In addition,in the treatment of DN, PGE1 have less adverse effect. Even for elderly patients (60 years of age), it is still safe with high clinical value.