Abstract： Objective： To observe the clinical effect and safety of Huoxue Zhuyu tang combined with nicorandil for microvascular angina(MVA). Methods：A total of 88 cases of MVA patients were selected and divided into the control group and the observation group according to the random number table method，44 cases in each group. Both groups were treated with western medicine，for example，aspirin，metoprolol and rosuvastatin；the control group was additionally treated with nicorandil，and the observation group was additionally treated with Huoxue Zhuyu tang based on the treatment of the control group. Both groups were continuously treated for three courses，four weeks being a course. The clinical effect was compared between the two groups. The changes in levels of endothelin-1(ET-1)，nitric oxide(NO)，high-sensitivity C-reactive protein (hs- CRP) in plasma， the frequency of angina pectoris， the duration of each angina pectoris， the degree of pain， and Chinese medicine syndrome scores before and after treatment were observed in the two groups. The incidence of adverse reactions was observed. Results：The total effective rate was 95.45% in the observation group，and 81.82% in the control group， the difference being significant(P＜0.05). After treatment， the level of NO in plasma in the observation group was higher than that in the control group， and the levels of ET- 1 and hs- CRP in plasma were lower than those in the control group， differences being significant(P＜0.05). After treatment， the frequency of angina pectoris and the duration of each angina pectoris in the observation group were less than those in the control group， and the degree of pain and Chinese medicine syndrome scores were lower than those in the control group， differences being significant(P＜0.05). During treatment， the liver- kidney function in the two groups were normal， and no significant adverse reaction occurred. Conclusion：The therapy of Huoxue Zhuyu tang combined with nicorandil for MVA can effectively improve endothelial function and clinical symptoms with high safety.