Clinical thinking plays a decisive role in the clinical diagnosis and treatment decisions. The article introduces the clinical thinking of Chinese medical surgery,including prior differentiation of yin and yang,importance of local syndrome differentiation and microscopic syndrome differentiation,combination of constitution differentiation and symptom differentiation that taking disease differentiation as the first and giving priority to syndrome differentiation,internal treatment for external diseases and emphasis on integrity and protection of spleen and stomach,treatment by stages and combination of internal and external treatment and underlining the external therapy. Establishment and reinforcement of clinical thinking of Chinese medical surgery are the key to improve the clinical efficacy,promote the academic level of Chinese medicine and revitalize Chinese medical surgery.