Ethyl 4-hydroxypethidine-1-carboxylate is mainly used as a pharmaceutical intermediate and a raw material for organic matter. It can be used in the synthesis of antihistamines, antipsychotics, antidepressants, and various pesticides. As an intermediate, the compound can also produce fungicides and insecticides. It can be used as a raw material for synthetic surfactants, flavors, and fragrances.