Abstract: Cadmium is an environmental heavy metal that can cause a variety of toxic reactions and is also an important positive control drug in drug toxicology research. The interrelated toxic effects of cadmium make its molecular mechanisms very complicated. The most important molecular mechanisms of cadmium toxicity were summarized in this article, including changes in gene expression, inhibition of damaged DNA repair, interference with cell apoptosis and autophagy, and induction of oxidative stress. Based on the molecular mechanisms and main target organs of cadmium toxicity, corresponding evaluation indicators and safety evaluation methods were summarized, such as histopathological examination, cadmium content detection, redox status detection (enzyme antioxidant system and non-enzyme antioxidant system marker determination), Western blotting and enzyme-linked immunosorbent assay for protein and enzyme content detection, and real-time polymerase chain reaction for gene expression detection. The article aimed to provide information for the exploration of potential molecular mechanisms of cadmium toxicity and for the safety evaluation of drugs with cadmium-like mechanisms.