OBJECTIVE： To observe clinical efficacy of Sihuang paste for external use in the treatment of subcutaneous hematoma of arteriovenous fistula in patients undergoing hemodialysis. METHODS： 64 patients undergoing hemodialysis and puncture hematoma were selected and randomly divided into observation group and control group， with 32 cases in each group. Control group used 50％ magnesium sulfate wet compress for hematoma， maintaining 3.5-4.5 h，qd. Observation group was given Sihuang paste for external use and gauze package， qd. Both group was given 15 days of treatment and basic nursing was given at the same time. Clinical efficacy was compared between 2 groups， and hemodialysis blood volume， sclerosis diameter and hematoma disappearance time were observed in 2 groups after treatment. RESULTS： The rate of excellent efficacy in observation group was 96.87％ （31/32）， which was significantly higher than that of control group （59.38％， 19/32）， with statistical significance （P＜0.05）. After treatment， hemodialysis blood volume of observation group was （254.6±45.8）ml/min， which was significantly higher than that of control group （210.5±20.5）ml/min， with statistical significance （P＜0.05）. After treatment， the sclerosis diameter and hematoma disappearance time of observation group were （1.4±0.1）cm and （5.6±4.3）d， significantly lower than （4.3±0.4）cm and （10.8±3.7）d of control group， all with statistical significance （P＜0.05）. CONCLUSIONS： Sihuang paste can rapidly improve subcutaneous hematoma and reduce sclerosis， recover the normal elasticity of blood vessels and improve blood flow of hematoma for hemodialysis patients.