Abstract: Objective To analyze the clinical efficacy of external application of self-formulated Qingre Lishi Tongluo Formula combined with local acupuncture in the treatment of rheumatoid arthritis (RA) with damp-heat obstruction pattern. Methods A total of 83 patients with damp-heat obstruction pattern RA admitted to Zhangjiakou Hospital of Traditional Chinese Medicine from September 2022 to March 2024 were selected. They were divided into two groups according to the random number table method. All enrolled patients received conventional Western medicine treatment; among them, 41 patients in the acupuncture group underwent local acupuncture treatment, while 42 patients in the combined group received external application of self-formulated Qingre Lishi Tongluo Formula in addition to the acupuncture treatment. The clinical efficacy, traditional Chinese medicine syndrome scores, inflammatory factor levels, pain intensity, joint function and incidence of adverse reactions of the two groups were compared after 12 weeks of treatment. Results The total effective rate in the combined group was higher than that in the acupuncture group (P < 0.05). At 12 weeks after treatment, the scores of morning stiffness, limitation of flexion and extension, joint tenderness, and joint swelling of patients in both groups were significantly lower than those before treatment (P < 0.05), and the scores in the combined group were lower than those in the acupuncture group (P < 0.05). At 8 and 12 weeks after treatment, the levels of C-reactive protein, erythrocyte sedimentation rate, rheumatoid factor, and interleukin-6 in the combined group were lower than those in the acupuncture group (P < 0.05). The visual analogue scale score and disease activity score using 28 joint counts in the combined group were lower than those in the acupuncture group after 8 and 12 weeks of treatment (P < 0.05). There was no statistically significant difference in the total incidence of adverse reactions between the two groups (P > 0.05). Conclusion The combination of external application of self-formulated Qingre Lishi Tongluo Formula and local acupuncture can improve clinical efficacy in patients with damp-heat obstruction pattern RA, effectively relieve clinical symptoms, reduce systemic inflammatory response, improve joint function, and demonstrate good safety.