Abstract：Objective：To observe the clinical effect of modified Pipa Qingfei Decoction combined with long pulse width 1064 nm laser in the treatment of rosacea. Methods： A total of 96 cases of patients with rosacea admitted to Wenzhou Hospital of Integrated Traditional Chinese and Western Medicine were selected and divided into the control group and the observation group according to the random number table method，with 48 cases in each group. The control group was treated with long pulse width 1 064 nm laser， while the observation group was treated with modified Pipa Qingfei Decoction on the basis of the control group. The clinical effects， symptom improvement time， the changes of traditional Chinese medicine （TCM） syndrome scores，erythema scores，papule scores，Acne-Specific Quality of Life Questionnaire（ Acne-QoL） scores，skin barrier indicators，and levels of interleukin-6（ IL-6），tumor necrosis factor- α（ TNF-α），and interleukin-4（ IL-4） were compared between the two groups，and the incidence of adverse reactions in the two groups were observed. Results： The total clinical effective rate was 95.83% （46/48） in the observation group， higher than the 83.33% （40/48） in the control group （P＜0.05）. The symptom improvement time such as improving of skin flush，fading of erythema，and resolution of telangiectasia in the observation group was shorter than that in the control group （P＜0.05）. After treatment， the TCM syndrome scores in the two groups were decreased compared with those before treatment （P＜0.05）， and the TCM syndrome scores in the observation group were lower than those in the control group （P＜0.05）. After treatment， the erythema scores and papule scores in the two groups were decreased when compared with those before treatment，and the Acne-QoL scores were increased compared with those before treatment（ P＜0.05）；the erythema scores and papule scores in the observation group were lower than those in the control group，and the Acne-QoL scores in the observation group were higher than those in the control group （P＜ 0.05）. After treatment， the stratum corneum hydration （SCH） in the two groups was increased compared with that before treatment，and the trans epidermal water loss （TEWL） was decreased compared with that before treatment （P＜ 0.05）；the SCH in the observation group was higher than that in the control group，and the TEWL in the observation group was lower than that in the control group （P＜0.05）. After treatment，levels of serum IL-6，TNF-α，and IL-4 in the two groups were decreased compared with those before treatment （P＜0.05）， and the levels of serum IL-6， TNF- α， and IL-4 in the observation group were lower than those in the control group （P＜0.05）. No statistically significant differences were observed in the comparison of the incidence of adverse reactions between the two groups （P＞ 0.05）. Conclusion：The therapy of modified Pipa Qingfei Decoction combined with long pulse width 1 064 nm laser can improve the skin scores and skin barrier function of patients with rosacea， reduce the inflammatory reaction， thus exerting certain clinical effects.