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Background The survival ratio of implanted mesenchymal stem cells (MSCs) in the infarcted myocardium is low.Autophagy is a complex self-eating process and can be utilized for cell survival.We have found that atorvastatin (ATV) can effectively activate autophagy to enhance MSCs survival during hypoxia and serum deprivation (H/SD).The mitogenactivated protein kinase/extracellular signal-regulated kinase (MEK/ERK) pathway is a non-canonical autophagy pathway.We hypothesized that the MEK/ERK pathway mediated ATV-induced autophagy of MSCs under H/SD.Methods MSCs were pretreated with ATV (0.01-10 μmol/L) under H/SD for three hours.For inhibitor studies,the cells were pre-incubated with the MEK1/2 inhibitor U0126.Cell autophagy was assessed by acidic vesicular organelles (AVO)-positive cells using flow cytometry,autophagy related protein using West blotting and autophagosome using transmission electron microscopy.Results Autophagy was elevated in the H/SD group compared with the normal group.ATV further enhanced the autophagic activity as well as the phosphorylation of ERK1/2 evidenced by more AVO-positive cells ((8.63±0.63)％ vs.(5.77±0.44)％,P ＜0.05),higher LC3-Ⅱ/LC3-Ⅰ ratio (4.36±0.31 vs.2.52±0.18,P ＜0.05) and more autophagosomes.And treatment with U0126 downregulated the phosphorylation of ERK1/2 and attenuated ATV-induced autophagy.Conclusion The MEK/ERK pathway participates in ATV-induced autophagy in MSCs under H/SD,and modulation of the pathway could be a novel strategy to improve MSCs survival.