Objective：To observe the clinical effect of tendon-regulating manipulation combined with external application of Huoxue Zhitong powder for old ankle sprain with qi stagnation and blood stasis syndrome.Methods：Divided 102 cases of patients with old ankle sprain into two groups according to the random number table method，51 cases in each group.The control group received tendon-regulating manipulation，while the treatment group was additionally treated with external application of Huoxue Zhitong powder.The two groups were treated for two weeks continuously.Compared the scores of ankle function， scores of visual analogue scale(VAS)and symptoms of qi stagnation and blood stasis(pain， swelling，bruising，thirst，constipation，dark urine)in the two groups，and compared the clinical effect.Results：The total effective rate in the treatment group was 100%，significantly higher than that of 88.24%in the control group(P＜0.05).Compared with those before treatment，the scores of ankle function were increased and the VAS scores were decreased in the two groups after treatment(P＜0.01).Compared with the control group after treatment，the score of ankle function in the treatment group was higher and the VAS score was lower(P＜0.01).Compared with those before treatment，the scores of qi stagnation and blood stasis syndrome(pain，swelling，bruising，thirst，constipation，dark urine)were decreased after treatment in the two groups(P＜0.01).Compared with that in the control group after treatment，the score of symptoms of qi stagnation and blood stasis was lower in the treatment group(P＜0.01).Conclusion：The therapy of tendon-regulating manipulation combined with external application of Huoxue Zhitong powder for old ankle sprain can obviously improve symptoms of qi stagnation and blood stasis，and improve the clinical effect.