This paper introduces Professor Huang Shilin’s clinical experience in treating primary myelofibrosis (PMF) based on the pathological feature of "bone depletion and marrow deficiency" .Professor Huang believes that PMF belongs to the category of "Gu Wei" (atrophic debility of bones)in traditional Chinese medicine (TCM), and its pathological feature is "bone depletion and marrow deficiency" . The basic pathogenesis is intermingled toxin and blood stasis, kidney asthenia and essence deficiency. Professor Huang has developed a distinctive treatment plan based on syndrome differentiation and staging treatment. He divides PMF into intermingled toxin and blood stasis syndrome and kidney asthenia and essence deficiency syndrome. The former is treated with the method of removing toxin and clearing heat, removing blood stasis and resolving stagnation; while the latter is treated with the method of strengthening body resistance and eliminating pathogenic factors, consolidating kidney and supplementing essence. Professor Huang also differentiates PMF into progressive stage and stable stage, and adopts integrated traditional Chinese and western medicine for treatment. To sum up, the therapeutic principles of removing toxin and resolving stasis, strengthening body resistance and eliminating pathogenic factors should be followed throughout the whole treatment process.