To investigate the clinical efficacy of Bushen Huoxue Decoction in treatment of early renal damage in patients with essential hypertension and its effect on the renal function, β2 microglobulin, MALb and lipid. Methods: Ninety-two patients with early kidney damage along with hypertension were divided into observation group (n=46) and control group (n=46) according to random number table. Patients in the control group were treated with conventional treatment and those in the observation group were additionally treated with Bushen Huoxue Decoction compared with the control group. Patients in the two groups received 12-week treatment. The total effective rate was compared between the two groups and the indexes of renal function, 2 microspheres protein, MAlb, blood lipid, 24 h blood pressure changes and adverse reactions were observed before and after treatment. Results: The total effective rate in the observation group (91.30%) was significantly higher than that of the control group (73.91%) (P<0.05); the Scr and BUN level in both groups were significantly decreased after the treatment (P<0.05) and those in the observation group were significantly lower than those of the control group (P<0.05). The β2-microglobulin and MALb levels in both the groups were significantly decreased (P<0.05) after treatment which were significantly lower than those of the control group (P<0.05). The ipid index levels, namely TC, TG, LDL-C and HDL-C, of both the groups showed no significant difference before and after treatment (P>0.05). The 24 h SBP and DBP in both the groups were significantly decreased after treatment (P<0.05) and the 24 h SBP and DBP in observation group were significantly lower than those of the control group (P<0.05). There were no serious adverse drug reactions in both groups during the treatment course. Conclusion: The clinical efficacy of Bushen Huoxue Decoction in treatment of early renal damage in patients with essential hypertension is significant, safe and reliable and may reduce the β2-microglobulin and MALb levels, and improve the renal function. There was no effect on the blood-fat, providing a significant research value.