The invention discloses azithromycin gel eye drops and a preparation process thereof. The eye drops are prepared from a main medicine, namely azithromycin and excipients such as an adhesive, a gel matrix, an isotonic regulator, a preservative, an antioxidant, a buffering agent and the like. The adhesive, namely polycarbophil in the eye drops can increase the biological adhesion of the eye drops, so that the detention time of medicines in eyes is further prolonged. The invention provides a practical, convenient and reliable ophthalmic preparation for treating bacterial conjunctivitis, and solves the problems that the detention time of medicines in an eye drop formulation in the eyes is short, the medicines are not easy to absorb, the bioavailability is low and the like.