A 63-year-old female patient received oral adefovir dipivoxil 10 mg once daily for chronic hepatitis B. She developed right knee and left shoulder pain at the 7th year of the treatment,followed by right hip pain and bilateral pain in the ribs,hips,knees and heels. Osteodynia progressed to the lower back and weakness and limited mobility in the 8th year. Laboratory tests showed the following values:serum phosphorus 0. 48 mmol/ L,calcium 2. 28 mmol/ L,uric acid 77 μmol/ L,urine glucose (+),urinary protein (++),urinary occult blood test (+),urinary β2-microglobulin 2. 5 mg/ L. Bone mineral density examination revealed osteopenia. Pelvic X-ray examination showed the osteoporosis of the hip and right femoral neck fracture. The patient was diagnosed as adefovir dipivoxil-induced Fanconi syndrome and pathological femoral neck fracture. Adefovir dipivoxil was stopped and her therapy was changed to entecavir 0. 5 mg once daily. She was given IV infusion of fructose diphosphate 10 g once daily and 5％ sodium bicarbonate injection 125 ml once daily,oral calcium carbonate 1500 mg once daily and alfacalcidol soft capsules 0. 25 μg thrice daily. One week later,the right femoral head replacement combined with the right femoral shaft fracture plate fixation was performed. The above-mentioned drugs were continued. After 5 weeks of adefovir dipivoxil discontinuation,serum phosphorus was 0. 72 mmol/ L,uric acid was 136 μmol/ L, urinary protein (+)and the osteodynia was significantly alleviated. After 5 months of adefovir dipivoxil withdrawal,laboratory tests showed the following values:serum phosphate 0. 87 mmol/ L,uric acid 215μmol/ L,urine glucose (-),urinary protein (-). Four months later,the serum phosphate was 1. 02 mmol/ L,the patient could walk normally.