This article reports a case of hypothyroidism caused by roxadustat,a prolyl-hydroxylase inhibitor,used to treat renal anemia.An 86-year-old male with a 10-year history of chronic renal insufficiency with reduced speech and food in-take for 3 weeks.After 4 months of medication,symptoms of hypothyroidism and abnormal laboratory tests appeared.Af-ter discontinuing roxadustat for one week,his thyroid function gradually normalized.For patients receiving roxadustat treatment,regular thyroid function monitoring is essential,and discontinuation or thyroid hormone replacement therapy should be considered if necessary.