Abstract： Objective： To observe the therapeutic effects of modified Taohong Siwu Decoction in treating diminished ovarian reserve（ DOR） of kidney deficiency and blood stasis type. Methods：A total of 108 DOR patients of kidney deficiency and blood stasis type admitted to the Third Affiliated Hospital of Wenzhou Medical University from April 2023 to April 2024 were randomly divided into the control group and the observation group by the envelope method， with 54 patients in each group. The control group was treated with Estradiol Valerate Tablets and Dydrogesterone Tablets， while the observation group received modified Taohong Siwu Decoction on the basis of the control group's treatment. The clinical effects and incidence of adverse reactions were compared between the two groups. The menstrual condition scores， syndrome scores of kidney deficiency and blood stasis， serum sex hormone levels [follicle-stimulating hormone （FSH） ， luteinizing hormone （LH） ， estradiol （E2） ， progesterone （P） ， prolactin （PRL），anti-Müllerian hormone （AMH），FSH/LH]，and ovarian stromal artery blood flow parameters [peak systolic velocity （PSV）， pulsatility index （PI）， resistance index （RI）] before and after treatment were compared between the two groups. Results：After treatment，the menstrual condition scores and the syndrome scores of kidney deficiency and blood stasis were decreased in both groups when compared with those before treatment （P＜0.05），and the scores in the observation group were lower than those in the control group （P＜0.05）. After treatment，the levels of FSH，LH，PRL，and FSH/LH were decreased in both groups when compared with those before treatment （P＜0.05）， while the levels of E2，P，and AMH were increased （P＜0.05）. The levels of FSH，LH，PRL，and FSH/LH in the observation group were lower than those in the control group （P＜0.05）， while the levels of E2， P， and AMH were higher （P＜0.05）. After treatment， the PSV values were increased in both groups when compared with those before treatment （P＜0.05），while the PI and RI values were decreased （P＜0.05）. The PSV value in the observation group was higher than that in the control group（ P＜0.05），and the PI and RI values were lower（ P＜0.05）. The total effective rate of clinical effect was 94.44%（51/54） in the observation group and 79.63%（43/54） in the control group， the difference being significant between the two groups （P＜0.05）. No serious adverse reactions occurred in either group during the treatment period. Conclusion： Modified Taohong Siwu Decoction is effective in treating DOR of kidney deficiency and blood stasis type，which can effectively alleviate clinical symptoms，improve ovarian reserve function， and is highly safe.