Abstract：Objective：To observe the clinical effect of Buyang Huanwu Decoction combined with Rivaroxaban in the treatment of deep veinous thrombosis of lower limbs （LDVT） after ischemic stroke of qi deficiency and blood stasis type.Methods：A total of 118 LDVT patients hospitalized in Wenzhou Hospital of Integrated Traditional Chinese and Western Medicine from July 2022 to June 2023 after ischemic stroke with qi deficiency and blood stasis type were randomly divided into control group and observation group with 59 cases in each group according to envelope method. One case in the control group was excluded for fail to take Chinese medicine orally follow doctor's advice，and one case in the observation group was excluded for early discharge from the hospital， and finally， 58 cases in each group completed the study.Both groups received conventional treatment. The control group was treated with Rivaroxaban on the basis of conventional treatment，and the observation group was treated with Buyang Huanwu Decoction combined with Rivaroxaban on the basis of conventional treatment， Both groups were treated for 14 days. The clinical efficacy， tradional Chinese medicine （TCM） syndrome score，Stroke Scale （NIHSS） score，Barthel Index （Barthel） score and Villalta score， blood clotting index [D-Dimer （D-D）， homocysteine （Hcy）， fibrinogen （FIB）， prothrombin time （PT）， activated partial thromboplastin time （APTT）， thrombin time （TT）] level of the two groups was compared. Results：After 14 days of treatment，the total effective rate of the observation group was 93.10% （54/58）， higher than that of the control group 82.76%（48/58） （P＜0.05）. After 7 and 14 days of treatment， TCM syndrome scores in the two groups were lower than those before treatment， and TCM syndrome scores in the observation group were lower than those in the control group （P＜0.05）. After 7 and 14 days of treatment，NIHSS score and Villalta score in the two groups were lower than those before treatment，and NIHSS score and Villalta score in observation group were lower than those in control group （P＜0.05）. After 14 days of treatment，the NIHSS score and Villalta score in the two groups were lower than that after 7 days of treatment （P＜0.05）.After 7 and 14 days of treatment，Barthel scores in the two groups were higher than those before treatment （P＜0.05）. After 14 days of treatment，the Barthel score in the two groups was higher than that after 7 days of treatment，and the observation group was higher than the control group （P＜ 0.05）. After 7 and 14 days of treatment，the levels of D-D，Hcy and FIB in the two groups were lower those than before treatment （P＜0.05）； after 14 days of treatment， the levels of D-D， Hcy and FIB indexes in the two groups were lower than those after 7 days of treatment （P＜0.05）. After 7 and 14 days of treatment，PT，APTT and TT in the two groups were longer than those before treatment，and PT in observation group was longer than that in control group at the same period（P＜0.05）；after 14 days treatment，PT，APTT and TT in the two groups were longer than those after 7 days treatment （P＜0.05）. There were no adverse reactions in both groups. Conclusion：The combination of Buyang Huanwu Decoction and Rivaroxaban can improve clinical symptoms，reduce D-D and Hcy levels，effectively improve coagulation function，and exert a synergistic anticoagulant effect in the treatment of LDVT after stroke of qi deficiency and blood stasis type.