The Fibroblast Growth Factor 23 (FGF23) is a recently discovered hormone, predominately produced by osteoblasts/osteocytes, whose major functions are to inhibit the renal tubular phosphate reabsorption and to suppress the circulating 1,25(OH)2D level. The chronic kidney disease (CKD) is a public health epidemic that would affect millions of people worldwide. The disordered phosphate homeostasis with elevated circulating levels of FGF23 is an early and pervasive complication of CKD. In this paper, we review the FGF superfamily, the mechanism of FGF23 in the phosphate and vitamin D metabolisms, and the relationship between FGF23 and PTH in CKD. In addition, we discuss the role of FGF23 in assessing the progression and the prognosis in CKD. The assessment of FGF23 may become an important diagnostic marker as well as a therapeutic target for the management of disordered bone and mineral metabolisms in CKD.