Abstract: Objective To observe the clinical efficacy and adverse reactions of mesylate apatinib versus docetaxel for advanced non-small cell lung cancer after failure of second-line treatment. Methods Clinical data about 128 patients with advanced NSCLC admittted to our hospital from March 2016 to June 2017 were analyzed. The observation group (n=60) was treated with apatinib(500 mg/d) and the control group (n=68) was treated with docetaxel (75 mg/m²). Treatment cycle of the two groups was 21 d. The clinical efficacy and adverse reaction of two groups were evaluated in every 2 cycles. Results The clinical evaluation was performed in 128 patients. The mPFS and DCR in apatinib were significantly greater than those in docetaxel group (3.7 months vs 3 months, 61.7% vs 48.6%, P< 0.05, respectively). The ORR of docetaxel group was lower than that of apatinib group, but the difference was not statistically significant (20.0% vs 19.1%, P> 0.05). As for improving the quality of life, apatinib was superior to docetaxel with significant difference (P< 0.05). The incidence rate of serious adverse reactions of apatinib was 18.3% (11/60), which was significantly lower than 29.4% (20/68) in docetaxel group (P< 0.05). Most of the adverse effects of these two drugs were gradeⅠorⅡ, which could be tolerated by most of the patients after symptomatic treatment. Conclusion The mesylate apatinib can be used for the advanced NSCLC treatment, and the clinical efficacy is superior to docetaxel with higher safety and longer survival time.