OBJECTIVE： To observe the clinical efficacy and safety of of heat-sensitive moxibustion combined with modified Pipa qingfei decoction for acne vulgaris. METHODS： A total of 120 patients with acne vulgaris were randomly divided into control group and observation group， with 60 cases in each group. Control group was given Minocycline hydrochloride capsules 50 mg/d， bid. Observation group was given heat-sensitive moxibustion （every other day） combined with modified Pipa qingfei decoction （one dose every day， decocting to 300 mL， morning and night）. Both groups were treated for 42 d.  Skin lesion score and serum testosterone level were observed in 2 groups before treatment， 1st and 90th day after the end of treatment. Clinical efficacies were evaluated in 2 groups on 1st and 90th day after the end of treatment， and the occurrence of ADR was observed in 2 groups during treatment. RESULTS： Before observation，there was no significant difference in these indexes. On 1st day after the end of treatment， the scores of skin lesion items and serum testosterone level in 2 groups were all decreased significantly compared to before treatment， and the scores of skin lesion items in observation group were significantly lower than control group （P＜0.05）； there was no significant difference in the serum testosterone level between 2 groups （P＞0.05）. On 90th day after the end of treatment， the scores of skin lesion items and serum testosterone level in control group had no statistical significance compared to before treatment （P＞0.05）. The scores of skin lesion items and serum testosterone level in observation group were decreased significantly compared before treatment， and were significantly lower than control group at corresponding period （P＜0.05）. On 1st and 90th day after the end of treatment， total response rates of observation group were 85.00％ and 73.33％， which were significantly higher than 73.33％ and 55.00％ of control group， with statistical isgnificance （P＜0.05）. There was no statistical significance in the incidence of ADR between 2 groups （P＞0.05）. CONCLUSIONS： The heat-sensitive moxibustion combined with modified Pipa qingfei decoction can significantly reduce the scores of skin lesion and serum testosterone levels， improves the symptoms of skin lesions， and shows good safety.