Abstract：Objective：To observe the clinical effect of Xijiao Dihuang tang combined with methotrexate for episcleritis and its effect on levels of inflammatory factors in aqueous humor. Methods：A total of 104 cases of patients with episcleritis were randomly divided into two groups，52 cases in each group. The control group was given oral administration of methotrexate tablets based on basic treatment，and the observation group was additionally treated with Xijiao Dihuang tang based on the treatment of the control group. The clinical effect， intraocular pressure， adverse reactions as well as the levels of inflammatory factors such as interleukin- 1β(IL- 1β)， interleukin- 6(IL- 6( and tumor necrosis factor- α(TNF- α) in aqueous humor before and after treatment were observed in the two groups. The recurrence rate was recorded during one- year follow- up. Results： The total effective rate was 92.31% in the observation group and 73.08% in the control group， the difference being significant(P＜0.05). After treatment，the contents of TNF-α，IL-1 and IL-6 in aqueous humor in the two groups were all decreased when compared with those before treatment(P＜0.05)，and each index in the observation group was significantly lower than that in the control group(P＜0.05). After treatment， the intraocular pressure in the observation group was significantly lower than that in the control group， the difference being significant(P＜0.05). The incidence of adverse reactions was 5.77% in the observation group and 7.69% in the control group， there being no significance in the difference(P＞0.05). During one-year follow-up，the recurrence rate was 19.23% in the observation group and 38.46% in the control group， the difference being significant(P＜0.05). Conclusion： Xijiao Dihuang tang combined with methotrexate has significant clinical effect， which can effectively reduce the levels of inflammatory factors in aqueous humor and the recurrence rate.