Abstract: Diabetic kidney disease(DKD) has become the leading cause of end-stage kidney disease(ESKD) in China.Activation of alternative pathway complement system is involved in the occurrence and development of DKD.Under hyperglycemia, glycosylation pattern recognition molecules can activate complement regulatory proteins, resulting in an excessive activation of alternative complement pathway.Effective blockade of alternative complement pathway may be a novel therapeutic approach for DKD.This review summarized the mechanism of activating alternative pathway in DKD and targeting the alternative pathway of complement system for treating DKD.