Abstract： Objective： To observe the clinical efficacy of medicinal separated umbilical moxibustion on chemotherapy-induced cancer-related fatigue in breast cancer of qi deficiency type. Methods： A total of 60 breast cancer patients of qi deficiency type with cancer-related fatigue after chemotherapy， treated at the Higher Education Mega Center Hospital of Guangdong Provincial Hospital of Chinese Medicine from January 2023 to January 2024，were selected and randomly divided into an observation group and a control group using the random number table method， with 30 cases in each group. Both groups received standardized chemotherapy. The control group received basic care for cancer-related fatigue during the peri-chemotherapy period，while the observation group received additional medicinal separated umbilical moxibustion based on the control group's routine interventions. Clinical efficacy， traditional Chinese medicine syndrome scores，Revised Piper Fatigue Self-Assessment Scale （PFS-R） scores，Chinese version of the Quality of Life Instrument for Cancer Patients （QLICP） scores，immune function indicators （CD3+，CD4+，CD8+， CD4+/CD8+ ratio） ， and hypothalamic-pituitary-adrenal （HPA） axis function indicators [adrenocorticotropic hormone （ACTH），cortisol （Cor）] before and after treatment were compared between the two groups. Results：After treatment， the total effective rate was 93.33% （28/30） in the observation group， significantly higher than that of 70.00% （21/30） in the control group （P＜0.05）. Traditional Chinese medicine syndrome scores and PFS-R scores decreased in both groups （P＜0.05）， while QLICP scores increased （P＜0.05）. The observation group had lower traditional Chinese medicine syndrome scores and PFS-R scores （P＜0.05） and higher QLICP scores （P＜0.05） than the control group. The levels of CD3+，CD4+，and CD4+/CD8+ increased in both groups （P＜0.05），while CD8+ levels decreased （P＜0.05）. The observation group had higher CD3+ ， CD4+ ， and CD4+/CD8+ levels （P＜0.05） and lower CD8+ levels （P＜0.05） than the control group. ACTH levels decreased in both groups （P＜0.05）， while Cor levels increased （P＜0.05）. The observation group had lower ACTH levels （P＜0.05） and higher Cor levels （P＜0.05） than the control group. Conclusion： Medicinal separated umbilical moxibustion improves clinical efficacy， alleviates traditional Chinese medicine syndromes，reduces fatigue，and enhances the quality of life in breast cancer patients of qi deficiency type with cancer-related fatigue after chemotherapy. Its mechanism may be related to improvements in immune function and homeostasis.