Abstract： Objective： To observe the clinical effect of Guben Antai Decoction combined with Dydrogesterone Tablets on recurrent spontaneous abortion (RSA). Methods：A total of 100 RSA patients of spleen-kidney deficiency type were selected and divided into the two groups according to the order of treatment by drawing lots， with 50 patients each. The control group was treated with Dydrogesterone Tablets， and the study group was treated with Dydrogesterone Tablets combined with Guben Antai Decoction. Compared the clinical effects， medication safety， and pregnancy outcomes between the two groups， and compared the progesterone levels and traditional Chinese medicine syndrome scores in the two groups before and after treatment. Results： The total effective rate was 94.00% in the study group， which was higher than that of 78.00% in the control group (P＜0.05). After treatment， the traditional Chinese medicine syndrome scores in both groups were decreased (P＜0.05)， and the score in the study group was lower than that in the control group (P＜0.05). After treatment， the levels of serum progesterone， estradiol， and chorionic gonadotropin were increased in both groups (P＜0.05)， and the levels of indicators above in the study group were higher than those in the control group (P＜0.05). Both groups were medicated until 12 weeks of pregnancy， and there showed no abnormality in the liver and kidney function tests，as well as routine blood，urine，and stool tests. The 28-week pregnancy rate in the study group was higher than that in the control group (P＜0.05). Conclusion： The combination of Guben Antai Decoction and Dydrogesterone Tablets can improve the progesterone levels and pregnancy outcomes in RSA patients of spleen-kidney deficiency type，with good efficacy and high medication safety.