Abstract: Objective To evaluate the effect of herbal remedy Yudan Decoction on treatment of acute cholestatic hepatitis. Methods Total of 86 patients with acute cholestatic hepatitis hospitalized from January 2009 to December 2011 in our hospital were selected and grouped into group A (45 cases with Western medical treatment only) and group B (41 cases with combined treatment of Western medicine and Yudan Decoction) randomly. After 8 weeks of treatment, the indexes of biochemistry, the score of traditional Chinese Medical Signs, the peak duration of jaundice and the treatment efficacy rate were compared between the two groups. Results In group A and group B, the declination of score of Traditional Chinese Medical Signs were (26.99 ± 2.02) and (28.13 ± 2.37), respectively; the median of reduction of TBil were 242.45 μmol/L and 312.65 μmol/L, respectively; the median of reduction of GGT were 57.00 U/L and 116.50 U/L, respectively; the median of reduction of ALP were 68 U/L and 91 U/L, respectively; the median of reduction of TBA were 170.50 μmol/L and 191.50 μmol/L, respectively; the efficacy rate were 80.00% and 95.12%, respectively, all with statistical significance (P = 0.032, 0.036). The median of reduction of ALT were 645.50 U/L and 613.25 U/L, respectively, without statistical difference (P = 0.897). Conclusions The treatment on patients with acute cholestatic hepatitis using the combination of Western medicine and Yudan Decoction is more effective than Western medicine alone, with declining of the score of Traditional Chinese Medical Signs, alleviating the biochemistry indexes and increasing the effectiveness rate. The dialectic method of Traditional Chinese Medicine in cooling down and reactivating the blood, dispelling the toxic heat and dissolving the dampness is worth promoting in the clinical treatment of acute cholestatic hepatitis.