Abstract: Berberine is an original antibacterial drug in China, and is widely used for its diverse biological functions. It is first used in clinic to treat intestinal bacterial infections. Berberine has different inhibitory effects on various microorganisms, but the effect is very weak with the minimum inhibitory concentration over 64 �g·mL^-1 in most of the study bacteria. The effect is better for Bacillus dysteriae, which is one aspect of its selectivity. At the same time, because of the poor absorption of berberine in oral administration, it is retained in the intestine to reach a high concentration, which provides a basis for tissue selectivity in the treatment of intestinal bacterial infections. In this paper, we reviewed the antibacterial action, mechanism, clinical application of berberine, in order to provide a clue for the future direction of berberine research.