Abstract: Multidrug resistance (MDR) limits the clinical application and efficacy of chemotherapy drugs. Thus, MDR is the big-gest obstacle to the success of chemotherapy. Complex and diverse MDR mechanisms exist, including the following: adenosine triphos-phate-binding cassette membrane transport protein family, anti-apoptotic or enhanced DNA repair, mutations in drug targets or metabol-ic enzymes, microRNA, and cancer stem cells. Autophagy can degrade organelles and proteins that have been damaged in the cyto -plasm through the formation of autolysosome and recycle metabolites. Maintaining intracellular homeostasis and a balanced internal en-vironment is highly significant. Recent studies found that autophagy is closely related to the pathophysiology of MDR. The interaction between autophagy and MDR and the possible molecular mechanisms underlying these phenomena are reviewed. This paper elucidates the occurrence of MDR in relation to autophagy in order to provide new information on chemotherapy MDR.