〔Abstract〕 Objective To evaluate the effect of Fuyang Tongluo method combined with alprostadil and Xuesaitong in the treatment of atherosclerosis obliterans and its effect on ankle brachial index (ABI) and coagulation function. Methods Ninety patients admitted to Luoyang Branch of Dongzhimen Hospital Affiliated to Beijing University of Chinese Medicine from August 2020 to August 2023 were selected. The patients were randomly divided into an observation group and a control group using a random number table method, with 45 cases in each group. The control group received treatment with alprostadil and Xuesaitong, while the observation group received treatment with Fuyang Tongluo method, alprostadil and Xuesaitong. The clinical treatment effects, and the traditional Chinese medicine (TCM) syndrome scores, ABI, fibrinogen (FIB), blood lipid levels, and vascular endothelial function related indicators before and after treatment were compared. Results The total effective rate of treatment in the observation group was significantly higher than that in the control group, and the difference was statistically significant (P < 0.05). After treatment, the TCM syndrome scores related to ulcers, claudication, pain, numbness, and coolness decreased in both groups of patients, and the TCM syndrome scores of the observation group were lower than those of the control group, with statistical significances (P < 0.05). The ABI of the observation group patients was higher than that of the control group, and the FIB level was lower than that of the control group, with statistical significances (P < 0.05). After treatment, the levels of serum total cholesterol (TC) and serum triglyceride (TG) in the observation group were lower than those in the control group, and the differences were statistically significant (P < 0.05). The level of serum nitric oxide (NO) in the observation group was higher than that in the control group, and the level of serum endothelin-1 (ET-1) was lower than that in the control group, with statistical significances (P < 0.05). Conclusion The curative effect of Fuyang Tongluo method combined with alprostadil and Xuesaitong is remarkable, which can improve the clinical symptoms of patients, improve ABI and coagulation function, reduce the blood lipid levels, and improve vascular endothelial function.