〔Abstract〕 Objective To observe the clinical effect of Smearing with traditional Chinese medicine on acute ankle fracture swelling. Methods 50 patients with acute ankle fracture treated in Sanming Integrated Medicine Hospital from January 2018 to December 2020 were randomly divided into observation group and control group. The control group was given routine treatment such as detumescence drugs, and the observation group was given traditional Chinese medicine smearing treatment on the basis of the control group. The clinical efficacy, visual analogue scale (VAS) score and quality of life of the two groups were observed. Results After treatment, the total effective rate of the observation group was 92.0%, which was significantly higher than 64.0% of the control group (P < 0.05). After treatment, the peak time of skin swelling and skin fold in the observation group were shorter than those in the control group (P < 0.05); After treatment, the VAS score of the observation group was lower than that of the control group (P < 0.05). There was no significant difference in the scores of emotional function, health status, physical pain and physiological function between the two groups before treatment (P > 0.05); after treatment, the above scores in the observation group were higher than those in the control group, and the differences were statistically significant (P < 0.05). Conclusion Traditional Chinese medicine smearing can effectively improve the limb swelling of patients with acute ankle fracture, reduce the pain feeling of patients and improve the quality of life of patients.