Abstract：Objective To investigate the clinical effect of methylprednisolone combined with irbesartan tablets on primary mesangial proliferative glomerulonephritis（MsPGN）. Methods    A total of 120 pathologically diagnosed MsPGN patients admitted in our hospital from January 2017 to June 2019 were selected, and randomly divided into observation group and control group with 60 cases in each group. The patients in the control group were given methylprednisolone and in the observation group were given methylprednisolone combined with irbesartan tablets for four weeks. The urinary albumin, 24-hour urinary protein, urinary nitrogen, endogenous creatinine clearance rate of the two groups before and after treatment were compared, and clinical efficacy and incidence of adverse reactions were compared between the two groups. Results After treatment, the urinary albumin and 24-hour urinary protein of the two groups were significantly decreased, and which in the observation group were better than that of the control group, the difference between groups were statistically significant（t＝18.649、7.400, all P＜0.05）. The remission rate of the observation group was higher than the control group（χ2＝5.885, P＜0.05）. The incidence of adverse reactions of the two groups were compared, and the difference was no statistically significant（χ2＝0.370, P＞0.05）. Conclusion Methylprednisolone combined with irbesartan tablets for MsPGN has significant efficacy and mild adverse reactions, which is worthy of application.