Abstract：Objective：To observe the clinical effect of self-formulated Bushen Huoxue Decoction combined with low-molecular-weight heparin sodium in treating recurrent spontaneous abortion （RSA）with kidney deficiency and blood stasis type. Methods： A total of 84 patients with RSA with kidney deficiency and blood stasis type treated at Pingdingshan Maternal and Child Health Care Hospital from January 2021 to December 2023 were selected and randomly divided into a control group and an observation group by random number table method， with 42 cases in each group. During the study， four cases from the control group and two from the observation group were excluded， leaving 38 cases in the control group and 40 cases in the observation group to complete the study. Both groups received conventional fetal preservation treatment. The control group was treated with low-molecular-weight heparin sodium， while the observation group received additional treatment with Bushen Huoxue Decoction. Treatment continued until the 28th week of pregnancy. Clinical effects，pregnancy outcomes，and the changes in traditional Chinese medicine（TCM） syndrome scores， estrogen levels， coagulation indicators， and uterine artery resistance parameters before and after treatment were compared between the two groups. Results： The total effective rate in the observation group was 95.00% （38/40）， higher than that in the control group at 76.32% （29/38） （P＜0.05）. After treatment， both groups showed significant decreases in the main syndrome scores and the secondary syndrome scores and TCM syndrome scores （P＜0.05）， with the observation group achieving lower scores than the control group （P＜0.05）. Serum progesterone （P）， β-human chorionic gonadotropin （β-HCG）， and estradiol （E2） levels were increased in both groups after treatment （P＜0.05），with the observation group showing higher levels than the control group （P＜0.05）. Serum D-dimer （D-D），plasminogen activator inhibitor-1 （PAI-1），and fibrinogen （Fib） levels were decreased in both groups （P＜0.05）， with the observation group having lower levels than the control group （P＜0.05）. Activated partial thromboplastin time （APTT） was prolonged in both groups after treatment （P＜0.05）， with the observation group showing a longer APTT than the control group （P＜0.05）. Uterine artery pulsatility index （PI）， resistance index （RI），and systolic/diastolic ratio （S/D） were decreased in both groups （P＜0.05），with the observation group achieving lower PI， RI， and S/D values than the control group （P＜0.05）. The fetal preservation success rate was 87.50% （38/40） in the observation group，higher than 68.42% （29/38） in the control group （P＜0.05）. Conclusion： Bushen Huoxue Decoction combined with low-molecular-weight heparin sodium is effective in treating RSA of kidney deficiency and blood stasis type. It can alleviate symptoms，improve estrogen levels and coagulation function，reduce uterine artery resistance，and increase the success rate of fetal preservation.