Abstract： Objective： To observe the clinical effect of hot compress with modified Wuzi powder for ankylosing spondylitis. Methods：A total of 120 cases of patients with ankylosing spondylitis were divided into the control group and the experiment group according to the random number table method ， with 60 cases in each group. The control group was given routine treatment of western medicine， and the experiment group was additionally treated with hot compress with modified Wuzi powder based on the treatment of the control group. The indexes of the Chinese medicine syndrome scores， inflammatory factors， spinal function and clinical signs before and after treatment and the clinical effects in the two groups were compared. Results：The total effective rate was 91.67% in the observation group，higher than that of 78.33% in the control group(P＜0.05). After treatment， the levels of the Chinese medicine syndrome scores， erythrocyte sedimentation rate(ESR)， C- reactive protein(CRP)， transforming growth factor-β2(TGF-β2)，receptor activator of nuclear factor-κB ligand(RANKL) and transforming growth factor- β1(TGF-β1) in the two groups were decreased when compared with those before treatment(P＜0.05)，and the above indexes in the experiment group were lower than those in the control group(P＜0.05). After treatment，the occiput- to- wall distances in the two groups were decreased when compared with those before treatment(P＜0.05)，and the Schober test and activity of thorax were increased(P＜0.05)，and the improvement in clinical signs in the experiment group was better than that in the control group(P＜0.05). The scores of Bath Ankylosing Spondylitis Metrology Index(BASMI)， Bath Ankylosing Spondylitis Disease Activity Index(BASDAI) and Bath Ankylosing Spondylitis Functional Index(BASFI) in the two groups were decreased when compared with those before treatment(P＜0.05)， and the decrease in the experiment group was larger than that in the control group(P＜0.05). Conclusion： Hot compress with modified Wuzi powder for ankylosing spondylitis can inhibit inflammatory responses in the body， and improve clinical signs，spinal function and clinical effects.