OBJECTIVE To observe the effect of xuebijing Injection (XI) on perioperative coagulation and inflammatory reaction in senile patients receiving total hip arthroplasty (THA). METHODS Totally eighty patients receiving THA at Luoyang Orthopedics Hospital, 65 to 85 years old, were randomly assigned to the control group (40 cases) and the treatment group (40 cases). All patients received routine perioperative therapies. Those in the treatment group received XI (adding 50 mL XI in 100 mL normal saline, 30 min each time). XI was continually injected after THA, twice daily for 3 successive days. Blood samples were harvested on the morning of the 2nd admission day (TO), immediately after operation (T1), on the morning of the 3rd day after operation (T3), and on the morning of the 5th day after operation (T4) to detect prothrombin time (PT), thrombin time (TT), activated partial thromboplastin time (APTT), levels of FIB and D-dimer (D-D), changes of white blood cell (WBC), neutrophils (N), C-reactive protein (CRP), erythrocyte sedimentation rate (ESR), and IL-6. Complications of surgery were compared between the two groups. RESULTS There was no statistical difference in operation time, intraoperative blood loss, and blood transfusion between the two groups (P >0.05). Compared with TO in the same group, WBC, N, CRP, ESR, IL-6, PT, TT, and D-D all increased in the control group at T1-T4 (P < 0.05); APTT increased at T1-T2 (P <0.05); FIB increased at T1-T3 (P <0.05). WBC, N, IL-6, PT, and D-D all increased in the treatment group at T1-T3 (P <0.05); CRP and ESR increased at T1-T4 (P < 0.05); TT increased at T1-T2 (P <0.05); APTT and FIB increased at T1 (P <0.05). Compared with the control group at the same time period, WBC, N, CRP, and IL-6 all decreased in the treatment group at T1-T4 (P <0.05), ESR decreased at T3-T4 (P <0.05); PT and TT decreased at T1-T3 (P <0.05); FIB and D-D decreased at T2-T4 (P<0.05). The occurrence of each complication was significantly lower in the treatment groups than in the control group. CONCLUSION XI could improve the perioperative high coagulation state of senile THA patients, inhibit inflammatory reactions, and reduce complications.