Abstract：Objective：To observe the clinical effect of Jianpi Huatan Qushi Prescription on metabolic associated fatty liver disease of internal obstruction of phlegm-turbidity type. Methods： A total of 108 patients with metabolic associated fatty liver disease admitted to Quzhou Hospital of Traditional Chinese Medicine from February to September 2024 were selected and divided into the combination group and the western medicine group according to the random number table method，with 54 cases in each group. During the treatment，2 cases were removed from the combination group and the western medicine group，respectively，and finally 52 cases were included. The western medicine group was treated with Polyene Phosphatidylcholine，and the combination group was additionally given oral administration of Jianpi Huatan Qushi Prescription based on the treatment in the western medicine group. After eight weeks of treatment， the clinical efficacy，traditional Chinese medicine syndrome scores，liver fat content，controlled attenuation parameter （CAP）， liver function [gamma glutamyl transpeptidase（GGT）， alanine aminotransferase（ALT）， and aspartate aminotransferase（AST）] and levels of blood lipid [total cholesterol（TC）， triglyceride（TG）， and low-density lipoprotein cholesterol（LDL-C）] were compared between the two groups. Results：The total effective rate was 94.23% （49/52）in the combination group and 80.77%（42/52）in the western medicine group，the difference being significant （P＜0.05）. After treatment，the traditional Chinese medicine syndrome scores in the two groups were decreased when compared with those before treatment（P＜0.05），and the above scores in the combination group were lower than those in the western medicine group（P＜0.05）. After treatment，the liver fat content and CAP in the two groups were reduced when compared with those before treatment（P＜0.05），and the levels of above two indexes in the combination group were lower than those in the western medicine group（P＜0.05）. After treatment，the levels of GGT，ALT and AST in the two groups were down-regulated when compared with those before treatment（P＜0.05），and the above three levels in the combination group were lower than those in the western medicine group（P＜0.05）. After treatment，the levels of TG，TC and LDL-C in the two groups were decreased when compared with those before treatment（P＜0.05），and the above three levels in the combination group were lower than those in the western medicine group（P＜0.05）. The incidence of adverse reactions was 5.77%（3/52）in the combination group and 3.85%（2/52）in the western medicine group， the difference being insignificant（P＞0.05）. Conclusion： Jianpi Huatan Qushi Prescription has a good curative effect on metabolic associated fatty liver disease of internal obstruction of phlegm-turbidity type， which is helpful to alleviate the condition，improve the liver function and the level of blood lipid，and has good safety.