Objective To investigate the clinical efficacy of herbal cake moxibustion in treating chronic renal failure. Methods Sixty CRF patients were randomly allocated to treatment and control groups, 30 cases each. The control group received medication and diet control and the treatment group, herbal cake moxibustion on Shenshu, Pishu or Ganshu in addition. Pre-/post-treatment differences in serum creatinine (Scr), blood urea nitrogen (BUN), endogenous creatinine clearance rate (Ccr) and 24-h urinary protein quantity were observed in the two groups and the clinical therapeutic effects were compared between the two groups after 3 months of treatment.Results The marked efficacy rate and the total efficacy rate were 46.7% and 86.7%, respectively, in the treatment group and 20.0% and 46.6%, respectively, in the control group, and there were statistically significant differences in both between the two groups (P<0.05). There were statistically significant pre-/post-treatment differences in Scr, BUN, Ccr and 24-h urinary protein quantity in the two groups (P<0.05). There were statistically significant post-treatment differences in Scr, BUN and 24-h urinary protein quantity between the treatment and control groups (P<0.05).Conclusion Herbal cake moxibustion is an effective way to treat chronic renal failure.