Acute kidney injury (AKI) is commonly encountered in critically ill patients and has important implications on short- and long-term clinical outcomes. Pharmacists must understand AKI definitions, diagnosis, and causes to provide appropriate medication recommendations. The use of biomarkers to define AKI and predict clinical outcomes remains an important area of research. Given the heterogeneous nature of AKI, there is increasing interest in identifying subphenotypes to more appropriately categorize and individualize AKI care. Pharmacists have an integral role in the prevention and management of AKI, including involvement in nephrotoxin stewardship, implementation of the Kidney Disease Improving Global Outcomes (KDIGO) AKI prevention bundle, and management of fluid and electrolyte complications. Use of clinical decision support systems and electronic alerts, combined with biomarker assessment and targeted interventions, may help mitigate the occurrence and progression of AKI. Pharmacists may also support AKI survivors in transitions of care including from hospital to home.