Objective To investigate the clinical efficacy of large spot modulated Q 1064 nm laser combined with Xiaoyao pills in the treatment of chloasma.Methods 90 patients with chloasma were treated in the hospital.The patients were randomly divided into 3 groups:treatment group were treated with Q 1064 nm laser combined with large spot Xiao Yao pill;the control group 1 was treated with large spot Q 1064 nm laser only,and control group 2 was treated with Xiaoyao Pill only.Results After 8 weeks of treatment,the effective rate was higher in the treatment group than the control group 2 (P＜0.05);after 16 weeks of treatment,the efficacy was better in the treatment group than the control group 1 and control group 2 (P＜0.05).The combination of the two methods can improve the curative effect and inhibit the recurrence.Conclusions The treatment of chloasma with large speckle modulated Q 1064 nm laser combined with Xiaoyao pills is effective and worthy of clinical promotion.