The treatment with gentamicin in the presence of pretreatment with bismuth nitrate significantly reduced blood urea nitrogen compared with given gentamicin alone. But the amelioration of gentamicin-induced nephrotoxicity by bismuth nitrate was abolished by pretreatment with indomethacin that is cyclooxygenase inhibitor, which significantly decreased renal glutathione S-transferase activity and thiobarbituric acid reactive substance compared with mice of given gentamicin and bismuth nitrate. On the other hand, treatment with bismuth nitrate significantly increased prostaglandin $E_2$ production in rat kidney slice. These results suggest that bismuth nitrate might ameliorate the nephrotoxicity of gentamicin via prostaglandin $E_2$ production.