A sensitive, rapid and accurate liquid chromatography-tandem mass spectrometric (LC-MS/MS) method with pre-column derivatization was developed for the simultaneous determination of erdosteine and its thiol-containing active metabolite in human plasma.  Paracetamol and captopril were chosen as the internal standard of erdosteine and its active metabolite, respectively.  Aliquots of 100 μL plasma sample were derivatized by 2-bromine-3'-methoxy acetophenone, then separated on an Agilent XDB-C₁₈ (50 mm × 4.6 mm ID, 1.8 μm) column using 0.1% formic acid methanol − 0.1% formic acid 5 mmol·L⁻¹ ammonium acetate as mobile phase, in a gradient mode.  Detection of erdosteine and its active metabolite were achieved by ESI MS/MS in the positive ion mode.  The linear calibration curves for erdosteine and its active metabolite were obtained in the concentration ranges of 5 − 3 000 ng·mL⁻¹ and 5 − 10 000 ng·mL⁻¹, respectively.  The lower limit of quantification of erdosteine and its active metabolite were both 5.00 ng·mL⁻¹.  The pharmacokinetic results of erdosteine and its thiol-containing active metabolite showed that the area under curve (AUC) of the thiol-containing active metabolite was 6.2 times of that of erdosteine after a single oral dose of 600 mg erdosteine tables in 32 healthy volunteers, The mean residence time (MRT) of the thiol-containing active metabolite was (7.51 ± 0.788) h, which provided a pharmacokinetic basis for the rational dosage regimen.