AIM: To study the effects of augmented renal clearance (ARC) on vancomycin pharmacokinetics, efficacy, and safety in patients with infective endocarditis, so as to provide better guidance for vancomycin medication. METHODS: The retrospective analysis was conducted. Patients data from the hospital medical record system from April 2020 to April 2023 during the cardiovascular surgery with use of vancomycin were collected. The subjects were divided into normal group and ARC group according to glomerular filtration rate (eGFR). According to the population pharmacokinetic model, the measured trough concentration was used for a Bayesian approach to estimate individual pharmacokinetic parameters and analyze influence of ARC on vancomycin pharmacokinetics. RESULTS: A total of 163 patients were included in this study. The incidence of ARC was 23.31%. The age of patients in ARC group was significantly lower than that in normal group  (P<0.05).  Moreover, the steady-state trough concentration (Cmin), trough concentration compliance rate, area under the curve (AUC), and elimination half life (t1/2) were significantly lower in ARC group than that in normal group (P<0.05). In addition, ARC group had significantly higher clearance (CL) and elimination rate than normal group (P<0.05). Correlation analysis showed that Cmin was positively correlated with AUC (r2=0.943, P<0.01 in normal group; r2 = 0.918, P<0.01 in ARC group). The trough concentration threshold corresponding to AUC> 400 mg·h·L-1 in normal group and ARC group were 12.78 mg/L and 13.32 mg/L, respectively. There was no significant difference in terms of clinical effectiveness between the two groups. Adverse reactions occurred in 15 patients in the normal group and 8 patients in the ARC group. CONCLUSION: ARC significantly affects the trough concentration, trough concentration compliance rate, and pharmacokinetic process of vancomycin  in patients with infective endocarditis. It is recommended to monitor and optimize vancomycin dosage regimen in patients with  infective endocarditis according to different renal function status and therapeutic drug monitoring for the purpose to facilitate individualized treatment.