〔Abstract〕 Objective To observe the clinical efficacy of Xuefu Zhuyu decoction in preventing vascular crisis after upper limb flap surgery. Methods Sixty patients undergoing upper limb flap transfer in Ganzhou City Nankang District First People's Hospital from January 2022 to January 2023 were selected and divided into an observation group and a control group by simple numerical random method, with 30 cases in each group. After operation, the control group was treated with "three antibodies", and the observation group was treated with Xuefu Zhuyu decoction on the basis of "three antibodies". The blood flow and overall efficacy of the postoperative flap were compared between the two groups. Results 3 days and 7 days after surgery, the flap swelling degree of patients in the observation group was better than that in the control group, and the difference was statistically significant (Z = -2.28, -3.46, P < 0.05). On day 1, day 3 and day 7 after surgery, the capillary response in the observation group was better than that in the control group, and the difference was statistically significant (Z = -6.89, -6.29, -7.35, P < 0.05). The efficacy of the observation group was better than that of the control group, and the difference was statistically significant (Z = -3.44, P < 0.05). Conclusion On the basis of conventional "three antibodies", Xuefu Zhuyu decoction can effectively reduce the occurrence of vascular crisis and increase the survival rate of skin flap.