OBJECTIVE To analyze the occurrence of adverse drug reactions （ADR） between bevacizumab biosimilars and original drugs， and to provide data support for rational use of drugs in clinical. METHODS ADR reports of bevacizumab biosimilars and original drugs reported by Jiangsu Cancer Hospital from January to December 2022 were retrospectively analyzed. RESULTS A total of 6 818 patients were treated with bevacizumab， and 136 ADR patients were reported. The incidence of ADR caused by bevacizumab biosimilars was higher than original drugs （2.18% vs. 0.71%， P＝0.004）. In ADR reports， the main treatment plan was bevacizumab combined with other tumor drugs （129 patients）； 118 patients were cured and improved； there were 108 general reports and 28 serious reports； the main system/organ involved in ADR was the cardiovascular system； there were no statistical significance in the incidence rates of hypertension/blood pressure increase， leukocyte/platelet decrease， diarrhea and fever caused by bevacizumab biosimilars and original drugs. CONCLUSIONS The incidence of ADR related to bevacizumab biosimilars is significantly higher than that of the original drugs， but there is no significant difference in the clinical manifestation of ADR. Clinicians can use bevacizumab biosimilars or original drugs based on the willingness of patients and their families.