Lithium salt as a common drug in the clinical treatment of bipolar disorder, its application range is very wide. Lithium ions have many physiological functions, such as improving hematopoietic function, regulating the nervous system, improving heart function, antiviral, immune regulation, and neuroprotective effects. Lithium also has numerous pharmacological effects. For example, it can be used as an emotional stabilizer and has anti-inflammatory effects in dermatology. It also has protective effects against various neurological diseases, leukopenia, hepatitis, pancreatic islet cells, etc. After oral absorption of lithium salt, it can regulate gastrointestinal epithelial ion transport, affect intestinal absorption and secretion, and repair mucosal damage to promote wound healing. In this review, we review in detail the current status of lithium on gastrointestinal physiology and pathology. Based on the multiple regulatory effects of lithium salts on the gastrointestinal tract, we expect to find new drug targets to better treat gastrointestinal diseases.