Objective: To study the effect of berberine on extracellular release of high mobility group box 1 (HMGB1) and its mechanism. Methods: The effect of berberine on release of HMGB1 and expression of HMGB1 mRNA were investigated in cultured macrophage-like RAW 264.7 cells after stimulation with lipopolysaccharide. The effect of berberine on serum HMGB1 level and survival rate of endotoxemia mice was also studyed. Results: Berberine(100μmol/L) markedly suppressed the release of HMGB1 and expression of HMGB1 mRNA from lipopolysaccharide-stimulated macrophages(P0.05). Serum HMGB1 level decreased, and the survival rate elevated from 28% to 56% at 96 hours, after endotoxemia mice were injected with berberine(5mg/ kg) intraperitoneally. Conclusion: Berberine was an effective inhibitor of HMGB1 release, and confered protection against endotoxin lethality.