Abstract：Objective：To observe the clinical effect of blood-letting puncture therapy combined with oral administration of ibuprofen and external application with Chinese herbal medicine for piriformis muscle syndrome(PMS). Methods：A total of 114 cases of PMS patients were randomly divided into the control group and the observation group，57 cases in each group. The control group was given oral administration of ibuprofen sustained release capsules combined with external application with Chinese herbal medicine，and the observation group was additionally given blood-letting puncture therapy based on the treatment of the control group. The scores of Visual Analogue Scale(VAS) and Oswestry Disability Index(ODI)， and the amplitude and latency of H-reflex of tibial nerve before and after treatment as well as the clinical effect and adverse reactions in the two groups were observed. Results：The total effective rate was 94.74% in the observation group and 80.70% in the control group，the difference being significant(P＜0.05). After treatment，the scores of ODI and VAS in the two groups were significantly decreased when compared with those before treatment(P＜0.05)，and the scores in the observation group were significantly lower than those in the control group(P＜0.05). After treatment，the latency of H-reflex of tibial nerve in the two groups was shortened when compared with that before treatment(P＜0.05)， and the one in the observation group was shorter than that in the control group(P＜0.05)；before and after treatment，there was no obvious change in the comparison of amplitude of H-reflex of tibial nerve between the two groups(P＞0.05). There was no local or general adverse reaction in the two groups during treatment. Conclusion： The therapy of blood- letting puncture therapy combined with oral administration of ibuprofen and external application with Chinese herbal medicine for PMS can significantly improve clinical symptoms and activity of daily living with significant clinical effect.