Principles of reptile treatment are significantly different from the drug therapy for mammals and birds, which is primarily due to anatomical and physiological peculiarities of reptiles. Gentamicin, which has a nephrotoxic effect, is used for the treatment of reptile infectious diseases. For the purpose of studying the effects of gentamicin of reptiles a serum biochemical analysis was conducted determining aspartate aminotransferase and alanine aminotransferase activity, urea and uric acid concentration. Two research groups of red-eared sliders (Trachemys scripta elegans) were formed for the study; every 48 hours they received an injection of gentamicin in a dose 10 mg/kg into thoracic limb muscles. The animals of the first research group were withdrawn from the experiment on the 7th day, and the animals of the second group were withdrawn on the 14th day of the research. As a result of parenteral administration of gentamicin in turtles, there is an increase in the concentration of uric acid and urea, as well as the activity of aspartate aminotransferases and alanine aminotransferases in blood serum. In the kidneys, structural changes of the glomeruli were found: alternative changes in podocytes, as well as degenerative and necrotic changes in the renal tubule epithelium. Degenerative changes of nephrocytes were accompanied by the dilation of smooth endoplasmic reticulum tubules, mitochondrial crista destruction, accumulation of autophagolysosomes, cytosomes and lysosomes in the cytoplasm. Furthermore, signs of nephrocyte apoptosis with the formation of apoptotic bodies were detected. A liver examination revealed dystrophic and necrotic changes in hepatocytes, expansion and overflow of the vessels of the venous beds.