Traditional model of ethics review for multi-center clinical trials is often criticized to be lack of efficiency and wasting of resource due to repetitive reviews, which also lead to insufficient human subject protection. Joint review mechanisms were hence developed and promoted by many countries for the purposes of enhancing quality and efficiency in ethics review as well as achieving better human subject protection. In this paper, the authors reviewed and analyzed the legislation and practice of joint ethics review mechanisms which were developed in US, UK, South Korea and Singapore, and explored the progress of JIRB, NRPB-IRB, and c-IRB in Taiwan. The author maintained that the development of joint ethics review mechanism is necessary and beneficial, and has proved to be effective in Taiwan. While improving efficiency and quality for ethics review, human subject protection can be actualized and biomedical research can be promoted.