Objective: To investigate the interaction between traditional Chinese medicine (TCM) syndromes of histiocytic necrotizing lymphadenitis (HNL) and pathological types of HNL, so as to discover the distribution rule of TCM syndromes for indiction of intervention of HNL. Methods: A total of 166 patients with HNL were included. The baseline data of the patients, clinical feature, the four diagnosis information of TCM and histopathological of cervical lymph node were collected. The syndromes of TCM were judged. The pathological types were confirmed by cervical lymph node biopsy. The Multi-way ANOVA was used to analyze the correlation between traditional Chinese medicine syndromes of HNL and its pathological types. Results: Among the 166 patients, the ratio of different types are as follow: wind-heat and phlegm-toxin syndrome (57.83%, 96/166), heat-toxin exuberance syndrome (34.34%, 57/166), and phlegm and blood stasis syndrome (7.83%, 13/166). The pathological types include proliferative type (57.83%, 96/166), necrotizing type (35.54%, 59/166), and xanthomatous type (6.63%, 11/166). There were significant differences in targeted lymph node diameter, pain scores, body temperature (F value were 3.737, 34.484, 34.805, all Ps<0.05), while the difference of WBC (F=1.194, P>0.05) among three TCM Syndrome types were notsignificant. There were significant differences in pain scores, body temperature (F value were 12.153, 25.931, all Ps<0.05), but not for the targeted lymph node diameter, WBC (F value were 2.249, 0.671, all Ps>0.05) among three pathological types. The corresponding analysis result showed that, on point sets, wind-heat and phlegm-toxin syndrome were correlated with proliferative type, heat-toxin exuberance syndrome correlated with necrotizing type, and phlegm and blood stasis syndrome correlated with xanthomatous type (χ²=235.100, P<0.001). Conclusions There is a close correlation between syndrome types of TCM and pathological types of HNL. The pathological change of wind-heat and phlegm-toxin syndrometends toproliferative type, heat-toxin exuberance syndrome tends to necrotizing type, and phlegm and blood stasis syndrome tends to xanthomatous type.