This review aims to compare and evaluate the therapeutic effect and safety of tacrolimus and cyclosporine, which are two effective immunosuppressive drugs treating chronic kidney disease. By reviewing other studies, the therapeutic mechanisms and side effect profiles of tacrolimus and cyclosporine are explored and compared in order to further comparison their effectiveness and safety. As their mechanisms are found to be similar, which is to block the signal transduction pathway leading to T-cell activation, more studies showed that tacrolimus appeared to be the better immunosuppressive agent compared to cyclosporine after conducting comparative experiments. Moreover, differences in their side effect profiles indicate that the dose and therapy conversion should be considered when tacrolimus and cyclosporine are used in clinical therapeutics of CKD. More research should be conducted to explore their pharmacokinetics, pharmacodynamics, and safety profiles so that getting a clearer understanding in their therapeutic mechanisms and a more advantageous reference for further clinical therapy selection.