Neonatal acute kidney injury (AKI) is more likely developed in preterm and very low birth weight infants. The incidence of AKI is increasing year by year in the neonatal intensive care unit. Due to the lack of effective prevention and control measures, the mortality rate is extremely high and the prognosis is very poor. Continuous renal replacement therapy (CRRT) is currently the ideal method for the treatment of neonatal AKI. At present, CRRT technology has been used in newborns both at home and abroad for more than 30 years. Although considerable treatment experience has been accumulated, a large number of problems remain to be solved. This article reviews the present state and precision management of CRRT in neonates.