To investigate the clinical curative effect of Tingli Dazao Xiefei Decoction in the treatment of pulmonary contusion complicated with acute respiratory distress syndrome. Methods: Two hundred patients with acute respiratory distress syndrome were randomly divided into the observation group and control group. Patients in the control group received routine treatment while patients in the observation group were given Tingli Dazao Xiefei decoction. Clinical therapeutic effects of the two groups were compared. Results: Total efficacy of patients in the observation group was significantly higher than that of the control group (P<0.05); IL-1, IL-6, TNF-α and CRP of both the two groups were significantly decreased with statistically significant difference (P<0.05). The patients in the observation group received better results compared with the control group (P<0.05), which showed statistically significant difference. The RR, PaCO2, PaCO2 and PaO2/FiO2 of the two groups were improved (P<0.05) and the observation group were more significantly improved compared with those of the control group (P<0.05). There was no significant difference in ICU transformation time and 28d case fatality rate between the two groups (P<0.05). Conclusion:Tingli Dazao Xiefei Decoction in the treatment of pulmonary contusion with acute respiratory distress syndrome may reduce the levels of inflammatory mediators, inhibit inflammatory reaction and effectively improve oxygenation, improving patient survival rate and reducing mortality.