To explore the epidemiological characteristics and major pathogenesis in Chinese Medicine according to the retrospective study of the first imported MERS case from Guodong province．Methods: The data from May 28, 2015 to June 11, 2015 of the epidemiology, syndromes and treatment of the case were collected and analyzed. Results: The patient was a middle-aged man with epidemiology characteristics roughly consistent with the previous investigation and had a history of hyperthyroidism and contact with confirmed cases of MERS. There were four stages as follows in the course of disease according to his changes of health condition. Firstly, at initial stage, disease location was in lung in the duration of first to fifth days. The patient was in fever with aching muscle but no chills, no sore throat, no cough or expectoration. The case in this period was mainly characterized with invading lung, light external pathogen while heavy interior evil. Secondly, in the developing period, the disease location was still in the lung, in the duration from seventh to 12th days. The patient had high fever without chills, dry cough with a little phlegm, thirst and bitter taste, shortness of breath. In this period heat evil was deep in qi. Thirdly, the very period, 12th to 22th days duration, the disease location was in the lung, stomach and large intestine. The patient had mild fever and abatement of fever, irritability, shortness of breath began to ease, headache, cough with a small amount of blood sputum, abdominal distension, no abdominal pain, diarrhea, fever, blood into the camp. During this period, the the 17th-18th was the most severe period, mainly manifested with headache, cough blood sputum, diarrhea, and was treated with antiviral, anti infection, immune enhancement agents. Fourthly, the recovering stage, the patient in this course after 22 days had no fever, disappeared sputum with blood, occasional dry cough, endurable headache and diarrhea alleviated. Conclusion: The initiating and fundamental factors in this case were warm febrile and epidemic toxin. Heat pathogen was the critical factor rather than toxin and blood stasis. The transform of symptoms conformed to defense-qi-nutrient-blood mode in febrile disease in TCM. Qi and defense level became ill at the same time. And the nutrient and blood level were not severe. Therefore, the patients condition in this case was not as severe as SARS, H1N1 influenza, H7N9 avian influenza.