Abstract： Objective： To observe the clinical efficacy of Buyang Huanwu Decoction combined with small needle knife in treating patients with lumbar disc herniation (LDH) complicated with sciatica. Methods： The data of 180 patients with LDH complicated with sciatica were retrospectively analyzed and divided into the trial group and the control group，each with 90 cases，according to different treatment methods. Both groups underwent lumbar traction treatment；the control group was additionally treated with small needle knife，and the trial group was additionally treated with Buyang Huanwu Decoction based on the treatment of the control group. Both groups were treated for four weeks. The nerve conduction velocity (motor nerve conduction velocity (MCV) of the tibial nerve， sensory nerve conduction velocity (SCV) of the peroneal nerve)，hemorheology indicators (plasma viscosity，hematocrit (HCT)，Numeric Rating Scale (NRS) scores， and Japanese Orthopaedic Association (JOA) scores in the two groups were compared before and after treatment，and the clinical efficacy in the two groups was evaluated. Results：The total effective rate was 94.44% in the trial group，and that of the control group was 82.22%，the difference being significant (P＜ 0.05). After treatment， the MCV of the tibial nerve and the SCV of the peroneal nerve in the two groups were increased when compared with those before treatment (P＜0.05)， and both indicators in the trial group were higher than those in the control group (P＜0.05). After treatment，the levels of plasma viscosity and HCT in the two groups were reduced when compared with those before treatment (P＜0.05)，and both indicators in the trial group were lower than those in the control group (P＜0.05). After treatment，the NRS scores in the two groups were decreased when compared with those before treatment (P＜0.05)，and the JOA scores were increased when compared with those before treatment (P＜0.05)；the NRS score in the trial group was lower than that in the control group (P＜0.05)，and the JOA score was higher than that in the control group (P＜0.05). Conclusion： Buyang Huanwu Decoction combined with small needle knife has a better curative effect in the treatment of LDH complicated with sciatica. It can effectively improve the nerve conduction velocity and hemorheology indicators of patients，significantly relieve pain，and improve lumbar function.