Objective: To explore the clinical effect of adding Bifidobacterium Trivalent Live Bacteria Capsules to ornithine aspartate in the treatment of subclinical hepatic encephalopathy. Methods: Seventy-five patients with subclinical hepatic encephalopathy admitted to our hospital from January 2020 to July 2024 were selected as the research subjects. The patients were divided into the control group (37 cases) and the observation group (38 cases) by the random number table method. All patients were given conventional treatment. The control group was treated with ornithine aspartate; The observation group was treated with Ornithine aspartate combined with Bifidobacterium Trivalent Live Bacteria Capsules. The liver functions of the two groups [serum Aspartate Transaminase (AST), Total Bilirubin (TBil), Alanine Transaminase (ALT)], blood ammonia, intestinal flora (Bifidobacterium, Lactobacillus, Enterococcus, yeast, Enterobacterium), the incidence of adverse reactions and hepatic encephalopathy were analyzed and compared. Result: At 8 weeks of treatment, the levels of AST, blood ammonia, ALT and TBil in the observation group were significantly lower than those in the control group (P < 0.05). At 8 weeks of treatment, the numbers of yeast and Enterobacter in the observation group were significantly lower than those in the control group, while the numbers of Lactobacillus, Bifidobacterium and Enterococcus were significantly higher than those in the control group (P < 0.05). During the treatment period, there was no significant difference in the incidence of adverse reactions between the two groups (P > 0.05). The incidence of hepatic encephalopathy in the observation group was significantly lower than that in the control group (P < 0.05). Conclusion: The combination of ornithine aspartate and Bifidus Trivalent Live Bacteria Capsules in the treatment of subclinical hepatic encephalopathy can improve the liver function and blood ammonia level of patients, promote the balance of intestinal flora, reduce the occurrence of hepatic encephalopathy, and will not increase adverse reactions.