Abstract： Objective： To observe the preventive effect of Bushen Quyu Decoction combined with Rivaroxaban on deep vein thrombosis (DVT) in patients after knee arthroplasty. Methods ： A total of 126 cases of patients receiving total knee arthroplasty were divided into the observation group and the control group according to the random number table method，with 63 cases in each group. After surgery， the control group was given the oral administration of Rivaroxaban， and the observation group was additionally treated with Bushen Quyu Decoction based on the treatment of the control group. The incidence of postoperative DVT， the changes in postoperative peripheral diameter difference of lower limbs， hemorheology indexes， coagulation indexes， and serum inflammatory factors， and the incidence of adverse reactions were compared between the two groups. Results： On the day 14 after surgery， the incidence of DVT was 3.17% in the observation group，lower than that of 14.29% in the control group (P＜ 0.05). On the day 14 after surgery，the circumference differences of thighs and legs in the two groups were decreased when compared with those on the day 1 after surgery (P＜0.05)， and the circumference differences of thighs and legs in the observation group were lower than those in the control group on the day 14 after surgery (P＜0.05). On the day 14 after surgery，the indexes of whole blood high-shear viscosity， hematocrit， plasma viscosity and platelet adhesion rates in the two groups were decreased when compared with those on the day 1 after surgery (P＜0.05)；the indexes of whole blood high-shear viscosity， hematocrit，plasma viscosity and platelet adhesion rate in the observation group were lower than those in the control group (P＜0.05). On the day 14 after surgery，thrombin time (TT) and activated partial thrombin time (APTT) in the two groups were increased when compared with those on the day 1 after surgery (P＜ 0.05)，and the levels of D-dimer (D-D) and fibrinogen (FIB) were decreased when compared with those on the day 1 after surgery (P＜0.05)；on the day 14 after surgery，TT and APTT in the observation group were longer than those in the control group (P＜0.05)，and the levels of D-D and FIB were lower than those in the control group (P＜0.05). On the day 14 after surgery， the levels of interleukin-8 (IL-8)， C-reactive protein (CRP) and tumor necrosis factor- α (TNF- α) in serum in the two groups were decreased when compared with those on the day 1 after surgery (P＜0.05)；on the day 14 after surgery，the levels of IL-8， CRP and TNF- α in serum in the observation group were lower than those in the control group (P＜0.05). There was no significant difference being found in the comparison of the incidence of adverse reactions between the two groups (P＞0.05). Conclusion： Bushen Quyu Decoction combined with Rivaroxaban can effectively prevent the occurrence of deep vein thrombosis in patients after knee arthroplasty，which can be related to the improvement of postoperative hypercoagulable state and inflammatory responses，with high treatment safety.