Abstract: Adverse drug reaction (ADR), a big issue in clinical medication, greatly affects drug efficacy and seriously threatens the safety of patients. With the rapid development of pharmacogenomics, the clinical correlation between gene polymorphism and ADR has been continuously confirmed, but there is a lack of comprehensive review. Based on Pharmacogenomics Knowledgebase (PharmGKB), pharmacogenomics-related guidelines published by the Clinical Pharmacogenetics Implementation Consortium (CPIC), the US Food and Drug Administration (FDA) and other authoritative organizations, this paper summarizes the significance and recent advances of gene polymorphism with high level of evidence in predicting and avoiding ADR, in order to provide reference for gene-directed individualized medication.