The invention relates to a method for rapid determination of blood concentration of methotrexate. The method comprises the following steps: firstly, adding a to-be-determined plasma sample into ammonium acetate -formic acid water solution, then, adding methanol solution containing MTX-d3 and eddying for 25s-35s, then, performing centrifugal separation, and then, collecting liquid supernatant, injecting the liquid supernatant into a rapid liquid chromatography system to perform separation analysis, then, injecting into a triple quadrupole mass spectrometer detector for detection, further performing data acquisition and processing through a chromatography software, and obtaining the blood concentration of the methotrexate. The method for rapid determination of blood concentration of methotrexate of the invention is rapid and accurate, highly sensitive, simple to operate and low-cost, and is suitable for clinical routine blood concentration monitoring. Preprocessing of the sample is simple, the amount of needed sample is low, so the method is suitable for clinical routine detection and pharmacokinetic study. An interior label is added in a sample preprocessing process, thus, accuracyof MTX quantification is improved, and specificity is high and sensitivity is high.