Abstract： Objective： To observe the effect of modified Taohong Siwu tang on hypercoagulabale state and levels of plasma von willebrand factor(vWF)， thromboxane B2(TXB2)， and homocysteine(Hcy) in patients with uremic undergoing hemodialysis. Methods：A total of 50 cases of patients with uremia who underwent maintenance hemodialysis were selected and divided into the Taohong Siwu tang group and the aspirin group according to the random number table method，25 cases in each group. Both groups were treated with hemodialysis，three times a week. The aspirin group was given aspirin entericcoated tablets，and the Taohong Siwu tang group was additionally given Taohong Siwu tang based on the treatment of the aspirin group. Both groups were treated for four weeks. Hemorrheology indexes，coagulation function indexes，levels of vWF，TXB2，and Hcy，as well as Chinese medicine syndrome scores before and after treatment were compared in the two groups. The clinical effect was evaluated in the two groups. Results：After treatment，levels of whole blood viscosity at high shear(HBV)，plasma viscosity(PV)，hematocrit(HCT)，and platelet aggregation rate(PAR) in the two groups were decreased when compared with those before treatment(P＜0.05). After treatment，levels of HBV，PV，HCT and PAR in the Taohong Siwu tang group were lower than those in the aspirin group(P＜0.05). After treatment，levels of vWF，TXB2，and Hcy in the two groups were decreased when compared with those before treatment(P＜0.05)，and the levels in the Taohong Siwu tang group were lower than those in the aspirin group(P＜0.05). After treatment，levels of fibrinogen(FIB) and D-dimer(D-D) in the two groups were decreased when compared with those before treatment(P＜0.05)，and the two levels in the Taohong Siwu tang group were lower than those in the aspirin group(P＜0.05). After treatment， scores of petechia and ecchymosis of limbs，dim complexion，localized paresthesia，limb numbness，as well as squamous and dry skin in the two groups were decreased when compared with those before treatment(P＜0.05)，and the five Chinese medicine syndrome scores above in the Taohong Siwu tang group were lower than those in the aspirin group(P＜0.05). The total effective rate was 96.00% in the Taohong Siwu tang group，higher than that of 68.00% in the aspirin group(P＜0.05). Conclusion：For patients with uremic undergoing hemodialysis， modified Taohong Siwu tang can improve their hypercoagulabale state， protect vascular endothelial function，and enhance the clinical effect.