Drugs cause several renal syndromes such as azotemia, fluid and electrolyte abnormalities, acute tubular necrosis, acute interstitial nephritis, and chronic interstitial nephritis. Acute tubular necrosis is most frequently caused by aminoglycoside antibiotics, radiographic contrast agents, and amphotericin B. The causes of acute interstitial nephritis are discussed also. Analgesic use and cyclosporine are important causes of chronic interstitial fibrosis. The pathogenesis and clinical management of renal toxicity due to these drugs is discussed.