Abstract： Objective： To observe the clinical effect of Bushen Huoxue tang combined with metformin for recurrent spontaneous abortion(RSA). Methods：A total of 95 cases of RSA patients were selected and divided into the control group and the observation group according to the random number table method，with 47 and 48 cases in each group respectively. The control group was treated with metformin，and the observation group was additionally treated with Bushen Huoxue tang based on the treatment of the control group. Clinical effects were compared between the two groups. Changes in levels of fibrinogen(FIB)，D- Dimer(D- D)，glycosylated hemoglobin(HbA1c)，homeostatic model insulin resistance index(HOMA- IR) and fasting insulin(FINS) before and after treatment in the two groups were compared. Results：The total effective rate was 95.83% in the observation group，higher than that of 82.98% in the control group，the difference being significant(P＜0.05). After treatment，the levels of FIB and D-D in the two groups were decreased when compared with those before treatment， and the two levels in the observation group were lower than those in the control group，differences being significant(P＜0.05). After treatment， levels of HOMA- IR， HbA1c， and FINS in the two groups were decreased when compared with those before treatment，and the three levels in the observation group were lower than those in the control group，differences being significant(P＜0.05). Conclusion： Bushen Huoxue tang combined with metformin for RSA can improve clinical effects， hypercoagulable state and insulin resistance.