Abstract：Objective：To observe the clinical efficacy of external application of Erhuang Powder in treating highrisk human papillomavirus （HR-HPV） cervical infection with dampness-heat pouring downward syndrome. Methods： Ninety-two patients with HR-HPV cervical infection with dampness-heat pouring downward syndrome treated at Ningbo Municipal Hospital of Traditional Chinese Medicine from January to December 2024 were divided into the observation group and the control group（46 cases each）using the random number table method. The control group received Recombinant Human Interferon α-2b Vaginal Effervescent Capsules，while the observation group was treated with external application of Erhuang Powder. Both groups underwent three treatment courses. Clinical efficacy， HRHPV negative conversion rates，vaginal microecological restoration rates were compared，traditional Chinese medicine syndrome scores，and immune function indicators（CD3+，CD4+，CD8+，CD4+/CD8+）were compared before and after treatment. Results： After three courses， the total effective rate was significantly higher in the observation group （91.30%，42/46）than in the control group（76.09%，35/46）（P＜0.05）. The HR-HPV negative conversion rate in the observation group（65.22%， 30/46）exceeded that in the control group（41.30%， 19/46）（P＜0.05）. Vaginal microecological restoration rates were 36.96%（19/46）in the observation group versus 17.39%（8/46）in the control group（P＜0.05）. Both groups showed reduced traditional Chinese medicine syndrome scores after treatment（P＜0.05）， with greater reduction in the observation group（P＜0.05）. The levels of CD3+ ， CD4+ ， and CD4+/CD8+ increased in both groups（P＜0.05），with higher levels in the observation group（P＜0.05）.The level of CD8+ in both groups was decreased compared with that before treatment（P＜0.05）， and the level of CD8+ in the observation group was lower than that in the control group（P＜0.05）. Conclusion：External application of Erhuang Powder alleviates symptoms， improves vaginal microecology， enhances immune function， and increases therapeutic efficacy for HR-HPV cervical infection with dampness-heat pouring downward syndrome.