Objective To explore clinical efficacy and safety of Qiangdu-Nianwang decoction on patients with ankylosing spondylitis (AS) and the TCM syndrome of kidney deficiency. Methods A total of 112 patients with AS who met the inclusion criteria weredivided into two groupsby random number table method, 56 cases in each group. The control group was treated with conventional therapy, while the study group was given Qiangdu-Nianwang decoction. The two groups were treated for 1 months continuously. TCM syndromes, Bath Ankylosing Spondylitis Disease Activity Index (BASDAI), Bath Ankylosing Spondylitis Functional Index (BASFI) and Bath Ankylosing Spondylitis Metrology Index (BASMI) was scored before and after treatment. The ELISA method was used to detect serum CRP level. The wechsler method was used to detect ESR. Aand clinical efficacy was evaluated. Results The total effective rate of the study group was 96.4％ (54/56) and the control group was 76.8％ (43/56). The difference between the two groups was statistically significant (χ2=9.314, P=0.002). After treatment, the scores of rachialgia, hypnalgia and total pain in the study group waswere significantly lower than those in the control group (t=8.980, 4.675, 9.686, P<0.01). The score of BASDAI, BASFI, BASMI and TCM syndromes was were significantly lower than those of the control group (t=14.117, 4.312, 7.665, 9.213, P<0.01). After treatment, the levelof ESR and CRP in the two groups was were significantly lower than those before treatment (P<0.05), and the levels of ESR and CRP in the study group was were significantly lower than those in the control group (t=9.128, 9.588, P<0.01). Conclusions The Qiangdu-Nianwang decoction on patients with AS and kidney deficiency has a good efficacy and low adverse reactions, can reduce the clinicalsymptoms, improve limb functions, and it was worthy clinical application.