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Cannabis (marijuana) continues to be the most commonly used illicit psychoactive substance globally. However little is known about trends of marijuana use in a large proportion of the world’s population, including in India. Some countries such as the United States have legalised marijuana use in some states for recreational and medicinal uses. In animal models, the endogenous cannabinoid (eCB) system plays a role in regulating kidney hemodynamics and sodium transport and may contribute to the pathogenesis of diabetic and obesity related nephropathy and kidney fibrosis. Although there is no evidence currently that marijuana use plays a role in the pathogenesis of kidney disease, data in humans are limited to case reports of AKI in the setting of synthetic cannabinoid use. The present review focuses on the role of the eCB system in normal kidney function and in various diseases.