To observe the clinical effects of Linggui prescription on adolescent acne vulgaris, and investigate the possible mechanism of it on immune regulation. Methods:Sixty-two cases of adolescent acne vulgaris and 20 healthy cases were involved in the study. After 10 days of Chinese herbal treatment, clinical efficient was evaluated, and also rate of CD14+TLR2+ and level of IL-4, IL-8, TNF-α and COX2 were detected in peripheral blood by Flow Cytometer and ELISA. Results:All cases had a clinical remission in different degree, rate of CD14+TLR+ in healthy control, pre-treatment and after-treatment group were （78±5）%, （92.3±6.7）%, （81.2±4.6）%. The rate had a significant decrease in after-treatment v.s. pre-treatment (P=0.044), level of IL-4, IL-8, TNF-α and COX2 were also markedly decreased after treatment (P<0.05). Conclusion:Linggui prescription might improve adolescent acne vulgaris through innate immunity regulation.