Sophorae tonkinensis Radix et Rhizoma is a commonly used traditional Chinese medicine in clinic. It has various pharmacological effects such as antibacterial

anti-inflammatory

antioxidant

anti-tumor

anti-viral

liver protection and immune regulation. It is clinically used to treat tumors

pharyngeal inflammation

hepatitis and other diseases. However

the adverse drug reactions are commonly reported. Toxicological studies have found that excessive dosage of Sophorae tonkinensis Radix et Rhizoma can bring toxic reactions to digestive system

nervous system

respiratory system

blood system

cardiovascular system and hepatobiliary system

etc. Among them

neurotoxicity is the most severe and harmful. This paper mainly reviews the chemical composition

imaging manifestations

neurotoxicity induced by irrational use（off-label dose

off-label course of treatment

long decoction time and irrational compatibility）

potential mechanism of action

poisoning prevention measures and post poisoning treatment methods

so as to provide reference for further exploring the pharmacological and toxicological mechanism

clinical rational use and avoiding toxicity of Sophorae tonkinensis Radix et Rhizoma.