Abstract: Objective To investigate the efficacy of combined acupuncture and herbal medicine therapy based on the "Tonifying and Clearing" theory, for the management of postpartum stress urinary incontinence (SUI) with the qi and blood deficiency pattern. Methods A total of 78 postpartum SUI patients admitted to Dahua Hospital, Xuhui District, between January 2023 and June 2024 were selected and randomly divided into Group A, B, and C, according to a random number table, with 26 patients in each group. Group A received combined acupuncture and herbal medicine based on the "Tonifying and Clearing" theory plus Kegel exercises therapy, Group B received acupuncture plus Kegel exercises therapy, and Group C received Kegel exercises therapy alone. All three groups were treated continuously for 4 weeks. Comparisons were made among the three groups for the following items after 4 weeks of treatment: clinical efficacy, pelvic floor muscle strength, maximum flow rate (Q_max), abdominal leak point pressure (ALPP), maximum urethral closure pressure (MUCP), Pelvic Floor Distress Impact Questionnaire-7 (PFIQ-7) and Pelvic Organ Prolapse/Urinary Incontinence Sexual Questionnaire-12 (PISQ- 12) scores, along with the recurrence rate at the 3-month follow-up. Results After 4 weeks of treatment, the total effective rate in Group A was significantly higher than that in Group C (P＜0.05). After 2 and 4 weeks of treatment, the pelvic floor muscle strength in Group A was superior to that in Group C (P＜0.05). The Q_max, ALPP, and MUCP in Group A were higher than those in Group B and Group C, and these indicators in Group B were higher than those in Group C (P＜0.05). The PFIQ-7 and PISQ-12 scores in Group A were lower than those in Group B and Group C, and these scores in Group B were lower than those in Group C (P＜0.05). Patients who achieved marked effectiveness or effectiveness in clinical treatment were followed up for 3 months. Group A and Group B both had a lower recurrence rate than Group C (P＜0.05). Conclusion The combined acupuncture and herbal medicine therapy based on the "Tonifying and Clearing" theory demonstrates significant efficacy for the treatment of postpartum SUI with the qi and blood deficiency pattern, improving pelvic floor muscle strength and urodynamic parameters, and reducing the recurrence rate.