Abstract： Objective： To observe the clinical effect of Qingfei Jianpi prescription for moderate to severe acne scar. Methods：A total of 120 cases of patients with acne scar were selected and divided into the control group and the observation group according to the random number table method， with 60 cases in each group. The control group was treated with routine western medicine，and the observation group was additionally treated with Qingfei Jianpi prescription based on the treatment of the control group. Both groups were treated for six weeks. Chinese medicine syndrome scores， skin lesion scores，scores of Echelle d'evaluation clinique des cicatrices d'acne(ECCA) and Dermatology Life Quality Index(DLQI) and the levels of interleukin-1(IL-1)，interleukin-6(IL-6) and tumor necrosis factor-α(TNF-α) in serum were compared between the two groups before and after treatment. The total effective rate and incidence of adverse reactions were compared between the two groups. Results：The total effective rate was 96.67% in the observation group，higher than that of 70.00% in the control group， the differences being significant(P＜0.05). After treatment， scores of Chinese medicine syndrome， skin lesions， ECCA and DLQI in the two groups were significantly decreased when compared with those before treatment(P＜ 0.05)，and the decrease in the observation group was larger than that in the control group(P＜0.05). After treatment，levels of IL- 1， IL- 6 and TNF- α in the two groups were significantly decreased when compared with those before treatment(P＜ 0.05)，and the inflammatory indexes in the observation group were lower than those in the control group(P＜0.05). There was no significant difference being found in the comparison of incidence of adverse reactions between the two groups(P＞0.05). Conclusion：Qingfei Jianpi prescription has a significant clinical effect in the treatment of moderate to severe acne scar. It can reduce the formation of skin lesions and acne scars and improve the quality of life of patients. Its mechanism may be related to improving the levels of IL-1，IL-6 and TNF-α in serum.