Abstract：Objective： To observe the clinical effect of the therapy of Xingnaojing Injection combined with Azithromycin on senile severe pneumonia and its influence on lung function and inflammatory factors. Methods：A total of 120 elderly patients with severe pneumonia were included and randomly divided into the control group and the study group，with 60 cases in each group. The control group was treated with Azithromycin， and the study group was additionally treated with Xingnaojing Injection based on the treatment of the control group. The total effective rates in the two groups were compared；the levels of inflammatory factors，including serum procalcitonin (PCT)，C-reactive protein (CRP)，interleukin-8 (IL-8)， interleukin-6 (IL-6) and interleukin-10 (IL-10)，and lung function indexes，including forced expiratory volume in the first second (FEV 1 )，ratio of FEV 1 to forced vital capacity (FVC) (FEV 1 /FVC) and maximum mid- expiratory flow (MMF)，were compared between the two groups before and after treatment. Results： After treatment，the total effective rate was 90.0% in the study group，higher than that of 75.0% in the control group，the difference being significant (P＜0.05). After treatment，the levels of PCT，CRP，IL-8， IL-6 and IL-10 in serum in the two groups were decreased when compared with those before treatment (P＜0.05)，and the above levels in the study group were lower than those in the control group (P＜0.05). After treatment，the levels of lung function indexes，including FEV 1 ，FEV 1 /FVC and MMF，were increased when compared with those before treatment in the two groups (P＜0.05)，and the above levels in the study group were higher than those in the control group (P＜0.05). Conclusion： The therapy of Xingnaojing Injection combined with Azithromycin for senile severe pneumonia can effectively reduce inflammatory reactions，improve lung function and improve clinical therapeutic effect.