Abstract: Objective This study aimed to explore the effects of Danggui Shaoyao powder on metabolic syndrome and ovulation function in obese women with polycystic ovary syndrome（PCOS） based on the "water-blood theory". Methods This study is a prospective randomized controlled trial that included 150 PCOS patients with overweight/obesity, who were randomly divided into three groups（50cases each）: group A（suggested diet）, group B（suggested diet+time-limited fasting）, and group C（suggested diet+Danggui Shaoyao powder）. The body composition, metabolic indicators, ovulation function, and sex hormone levels of the three groups before treatment,at weeks 7 and 14 of treatment were compared, and the menstrual status of the three groups before treatment, at months 1, 3, and 6 of treatment was compared. Results Repeated measures analysis of variance（ANOVA） showed that the time effects of body mass index and body fat percentage were significant among the three groups（<P ＜ 0.05）, and the interaction between time and groups was statistically significant（P ＜ 0.05）. The intergroup, temporal, and interactive effects of three groups of blood glucose and lipid indicators, sex hormone levels, ovulation function-related indicators, and traditional Chinese medicine syndrome scores were significant（P ＜ 0.05）. Bonferroni pairwise comparisons found that at weeks 7 and 14 after treatment, group C showed significant improvements in body mass index, body fat percentage, fasting blood glucose, fasting insulin, triglycerides, testosterone, luteinizing hormone, follicle stimulating hormone,endometrial thickness, number of dominant follicles, and cycle ovulation rate compared to groups A and B（P ＜ 0.05）. At the 1st, 3rd,and 6th months after treatment, the TCM syndrome scores of group C were significantly lower than those of groups A and B（P ＜ 0.05）,and the scores of each group continued to decrease over time（P ＜ 0.05）. Conclusion Based on the traditional Chinese medicine "waterblood theory", Danggui Shaoyao powder can effectively improve metabolic syndrome and ovulation function in obese women with PCOS,reduce sex hormone levels, and improve menstrual conditions.