Objective To investigate the functional connectivity of the insula with ventral neural system and the relationship with the clinical feature during emotion processing in major depressive disorder. Methods Twenty-seven patients with major depressive disorder(MDD) and well-matched healthy controls were enrolled in this study. They were asked to recognize the facial emotion during magnetoencephalograph (MEG) scanning. Then the magnetic signals of the sad face was extracted and further processed with the software of SPM8, with the interested regions including the amygdala(AMYG), the insula, the anterior cingulate cortex(ACC), the orbitofrontal cortex(OFC) and the ventromedial prefrontal cortex (VMPFC). The interested time series were selected between 0-600 ms, which was analyzed by the method of principal component analysis (PCA) to reduce the differences. The next step was to compute the effective connectivity of the interested brain areas with the approach of granger causality model(GCM). Results The effective connectivity from the OFC to the ACC was obviously enhanced in MDD(P=0.016), in addition with the connectivity from the insula to the VMPFC(P=0.022) and the ACC(P=0.006) to the insula. Furthermore, the value of the connectivity from the anterior cingulate cortex to the insula was positively correlated with the illness duration(r=0.392, P<0.05). Conclusions The enhanced connectivity of the increased communication between them, indicating the enhancement of the processing of sad stimuli. Our results indicate that the insula plays a pivotal role, not only in the resting-sate, but also in the emotion processing task. Key words: Depressive disorder; Insula; Magnetoencephalogram; Grander causal model