OBJECTIVE： To compare the efficacy and safety of domestic vancomycin and imported vancomycin in the treatment of methicillin-resistant Staphylococcus aureus （MRSA） caused lung infection after neurosurgery. METHODS： The patients after neurosurgery with MRSA pulmonary infection diagnosed in our hospital from Jan. 2014 to Jun. 2015 and using domestic vancomycin were included in domestic vancomycin group， while those who used imported vancomycin from Jul. 2015 to Dec. 2018 were included in imported vancomycin group. The baseline data of the two groups were matched by 1 ∶ 1 according to propensity  score matching method. The 30-day all-cause mortality， 90-day all-cause mortality of severe patients， 7 d effective bacterial clearance rate and the incidence of ADR were compared between 2 groups. RESULTS： There were 108 cases in domestic vancomycin group and 279 cases in imported vancomycin group. After propensity score matching， 108 cases in domestic and 108 cases in imported vancomycin group were finally included. The 30-day mortality rates of domestic group and imported group were 10.19％（11/108） and 7.41％（8/108） respectively， and the 90-day all-cause mortality of 22 pairs of severe patients were 63.64％. The 7 d effective bacterial clearance rates were 75.00％（48/64） and 81.94％（59/72）， and there was no statistical significance （P＞0.05）. The incidences of creatinine increase ＞1 fold were 25.93％（28/108） and 12.04％（13/108）， the total incidences of ADR were 29.63％（32/108） and 15.74％（17/108）， respectively， with statistical significance （P＜0.05）. CONCLUSIONS： The therapeutic efficacy of imported vancomycin is similar to that of domestic vancomycin in the treatment of postoperative pulmonary infection with MRSA after neurosurgery， but the safety needs to pay close attation， especially the rise of serum creatinime.