Objective:To observe the clinical efficacy of Jiawei arthromyodynia “San Liang San Decoction” combined with methotrexate in treatment of cold dampness and blood stasis rheumatoid arthritis  Methods:120 cases of patients with cold dampness and blood stasis rheumatoid arthritis were randomly divided into treatment group (80 cases) and control group (40 cases). The control group was treated with methotrexate orally; the treatment group was treated with Jiawei arthromyodynia “San Liang San Decoction” based on the treatment of the control group. Two groups were treated for 8 weeks. The clinical efficacy and safety were observed. The changes of linical symptoms and signs (TJC28, SJC28, VAS score), laboratory indexes (ESR, CRP), the condition assessment index (PGA, MDGA, CDAI) were compared  Results:①The total efficiency of the treatment group and the control group were 86.25% and 67.50% respectively. The difference of the clinical efficacy between the two groups was statistically significant (P<0.05). ② Compared before and after the treatment, the difference of TJC28, SJC28, VAS score of the two groups were statistically significant (P<0.05); after the treatment, the difference of TJC28, SJC28, VAS score between the two groups were statistically significant (P<0.05). ③Compared before and after the treatment, the differences of the levels of ESR, CRP of the two groups were statistically significant (P<0.05); the difference of HGB level in the treatment group was statistically significant (P<0.05), while had no statistically significant difference in HGB level in the control group (P>0.05). After the treatment, there was no statistically significant differences in ESR and CRP level (P>0.05) while the difference of HGB level was statistically significant (P<0.05). ④ Compared before and after the treatment, the difference of PGA, MDGA, CDAI index level were statistically significant (P<0.05); after the treatment, the difference of PGA, MDGA, CDAI index level was statistical significance (P<0.05). ⑤ The occurrence rate of adverse reactions of the two groups were compared, the difference was statistically significant (P<0.05)  Conclusion:Jiawei arthromyodynia “San Liang San Decoction” combined with methotrexate in treatment of cold dampness and blood stasis rheumatoid arthritis can relieve pain, reduce the disease activity, and has less adverse reactions.