Abstract：Objective：To observe the clinical effect of thumbtack needling combined with Chinese medicine hot compress package in the treatment of nausea and vomiting after lower limb fracture surgery in elderly. Methods：A total of 60 elderly patients with lower limb fractures who underwent elective surgery in the First Ward of Departemtnt of Orthopedics and Traumatology， Cangnan Hospital of Traditional Chinese Medicine from May to December 2024 were selected and divided into the control group and the study group by random coin toss method， with 30 cases in each group. Both groups fasted for 12 hours and abstained from water for 10 hours before surgery， received the same combined spinal-epidural anesthesia during surgery， and were given anti-infection， nutritional support and other symptomatic treatments after surgery. The control group was given metoclopramide hydrochloride 10 mg intramuscularly within 6 hours after surgery；the study group was treated with thumbtack needling combined with Chinese medicine hot compress package within 6 hours after surgery. The incidence and severity of nausea and vomiting within 48 hours after surgery， the scores of traditional Chinese medicine （TCM） syndromes before and after treatment， the overall therapeutic effect on postoperative nausea and vomiting，and the occurrence of adverse reactions during treatment were observed and compared between the two groups. Results：Ultimately，29 cases were included in the study group and 29 cases in the control group for statistical analysis. The incidence of nausea and vomiting in the study group at 6- 12 hours and 12-24 hours after surgery，and the total incidence of nausea and vomiting within 48 hours after surgery were lower than those in the control group，differences being significant （P＜0.05）. The severity of nausea and vomiting within 48 hours after surgery in the study group was lower than that in the control group， differences being significant （P＜0.05）. The TCM syndrome scores （nausea， vomiting， stuffiness and fullness in the chest and hypochondrium， decreased appetite） of both groups after treatment were lower than those before treatment， and the scores of all TCM syndromes in the study group were lower than those in the control group， differences being significant （P＜0.05）. The total effective rate was 96.55% （28/29） in the study group and 79.30% （23/29） in the control group， the difference being significant （P＜0.05）. There was no statistically significant difference in the total incidence of postoperative adverse reactions （drowsiness， dizziness and headache， skin allergy） between the study group and the control group （P＞0.05）. Conclusion： Thumbtack needling combined with Chinese medicine hot compress package for nausea and vomiting after lower limb fracture surgery in elderly can effectively reduce the incidence of early postoperative nausea and vomiting，alleviate the degree and symptoms of nausea and vomiting，an effect that is superior to metoclopramide hydrochloride alone，with good clinical effect and safety.