OBJECTIVE To investigate the mechanism of Jianpi Yishen Huazhuo Recipe in regulating ovarian function in rats with polycystic ovary syndrome(PCOS) through the Bax/Bcl-2/Caspase-3 pathway. METHODS SD rats were fed with a high-fat diet combined with letrozole to establish a model of PCOS. The successfully modeled rats were randomly divided into blank control group, model group, high-, medium-, and low-dose Jianpi Yishen Huazhuo Recipe groups, as well as positive drug metformin group. ELISA was used to detect the serum levels of LH, T, and LH/FSH in each group of rats. HE staining was used to observe the morphology of ovarian tissue. Immunohistochemistry and Western blotting was used to detect the protein expression of Bax, Bcl-2, and Caspase-3 in ovarian tissues of rats. RESULTS ELISA results showed that the levels of LH, T, and LH/FSH in each dose group of Jianpi Yishen Huazhuo Recipe significantly decreased, while the level of FSH significantly increased. HE staining results showed that ovarian tissue in each dose group of Jianpi Yishen Huazhuo Recipe was significantly improved. Immunohistochemistry results showed that Bax expression increased in granulosa cells, interstitial cells, and luteal cells, while Bcl-2 expression increased in oocytes, luteal cells, and follicular fluid. Caspase-3 expression increased in granulosa cells, oocyte membranes, and interstitial cells. Western blotting results showed that the relative expression of Bax and Caspase-3 proteins decreased in each dose group of Jianpi Yishen Huazhuo Recipe, while the relative expression of Bcl-2 protein increased, and the ratio of Bax/Bcl-2 decreased. CONCLUSION Jianpi Yishen Huazhuo Recipe can improve ovarian ovulation function by downregulating the expression of Bax and Caspase-3 proteins in ovarian tissue of PCOS rats, reducing the ratio of Bax/Bcl-2, upregulating the expression of Bcl-2 protein, adjusting the process of ovarian cell proliferation and apoptosis, improving the ovarian microenvironment, regulating endocrine levels, and promoting follicular development and maturation.