Abstract:Mycobacterium ulcerans infection can cause chronic skin ulceration——Buruli ulcer, leading to tissue necrosis, apoptosis and immune suppression. The relatively painlessness of ulcers during the early stage of infection will delay the treatment for patients. Mycolactone is the cytotoxic basis of M. ulcerans, which targets both immune cells and some nonimmune cells. In this review, the chemical structure, cytotoxicity and molecular targets of mycolactone were summarized, as well as questions for mycolactone.