Objective: To observe the therapeutic effect of Xijiaodihuang Decoction combined with halomethasone cream on psoriasis vulgaris (PSO) with blood-heat syndrome. Methods: 86 patients with psoriasis vulgaris (PSO) admitted to our hospital from January 2021 to January 2024 were selected as the study objects. The patients were divided into control group and study group by random number table, with 43 cases in each group. The control group was treated with halometasone cream; On the basis of control group, the study group was treated with rhinoceros jiao Dihuang decoction. The clinical efficacy, severity of the disease [PASI], inflammatory factors [interleukin-17 (IL-17), IL-23, IL-6, tumor necrosis factor-α, necrosis factor-α (TNF-α)] levels, quality of life [Dermatological Life Quality Index Scale (DLQI)] and adverse reactions of the two groups were analyzed and compared. Results: The total effective rate of the study group was significantly higher than that of the control group (P < 0.05). After treatment, the total PASI score of both groups was significantly lower than that before treatment, and the total PASI score of the study group was significantly lower than that of the control group after treatment (P < 0.05). After treatment, the levels of IL-17, IL-23, IL-6 and TNF-α in both groups were significantly lower than before treatment, and the levels of various inflammatory factors in the study group after treatment were significantly lower than those in the control group (P < 0.05). After treatment, DLQI scores of both groups were significantly lower than before treatment, and DLQI scores of the observation group were significantly lower than those of the control group after treatment (P < 0.05). There was no significant difference in the incidence of adverse reactions between the two groups (P > 0.05). Conclusion: The application of Xijiao Dihuang Decoction combined with halometasone cream in the treatment of blood-heat syndrome PSO can improve the therapeutic effect, reduce the severity of the disease and inflammatory reaction, improve the quality of life, and have high safety.