AIM：To investigate the protective effect of atorvastatin (ATO) against contrast medium (CM)-induced apoptosis of renal tubular epithelial cells in diabetic rats. METHODS：Streptozocin-induced diabetic Wistar rats were fed for 8 weeks and then randomly divided into 5 groups: diabetes mellitus (DM) group, DM with iopromide (a kind of CM) treatment group (DM+CM group), and groups of DM rats treated with ATO at 5 mg·kg-1·d-1 (ATO1 group), 10 mg·kg-1·d-1 (ATO2 group) and 30 mg·kg-1·d-1 (ATO3 group) before iopromide injection. Healthy Wistar rats served as normal controls (N group). Urine creatinine (UCr) and 24-hour urinary albumin (24 h-UAlb) were determined 24 h after iopromide injection. Serum creatinine (SCr) and blood urea nitrogen (BUN) were detected 48 h after iopromide injection, and then creatinine clearance (CCr) and 24-hour urinary albumin excretion rate (24 h-UAER) were calculated. The rats were sacrificed and both kidneys were removed 48 h after iopromide injection. For the left kidney, the morphology by HE staining, the renal tubular apoptosis by TUNEL and the expression of Bax and Bcl-2 by immunohistochemistry were detected. For the right kidney, the expression of Bax and Bcl-2 was measured by Western blotting. RESULTS：Compared with N and DM groups, the levels of SCr, BUN and 24 h-UAER, as well as the expression of Bax in the renal medulla were higher, the levels of Ccr and Bcl-2 expression in the renal medulla were lower and TUNEL-positive cells were more in DM+CM group. Compared with DM+CM group, ATO attenuated these changes, especially in ATO3 group. CONCLUSION: Iopromide could cause renal tubular apoptosis. Early application of ATO could dose-dependently attenuate the development of contrast-induced acute kidney injury, partly due to suppression of iopromide-induced renal tubular apoptosis.