Objective To observe the clinical efficacy of yin-nourishing and blood-activating prescription (YNBAP) in IgA nephropathy patients with yin-deficiency and blood-stasis syndrome. Methods Sixty IgA nephropathy patients with yin-deficiency and blood-stasis syndrome were randomly divided into treatment group (n=40) and control group (n=20). The control group was given angiotensin-converting enzyme inhibitor or angiotensin receptor blocker, while the treatment group received self-made YNBAP in addition to the angiotensin-converting enzyme inhibitor or angiotensin receptor blocker. The course of treatment was 12 weeks in both groups. After treatment, the two groups were compared in terms of improvements in IgA nephropathy and traditional Chinese medicine (TCM) syndrome. Before and after treatment, urine red blood cell (URBC) count, 24-hour urinary protein (24hUP) excretion, and serum creatinine (SCr) level were determined, and estimated glomerular filtration rate (eGFR) was calculated. Results Compared with the control group, the treatment group had a significantly higher overall response rate (72.50% vs 45.00%, P=0.037) and a significantly more improvement in TCM syndrome (P=0.015). After treatment, the treatment group showed significant decreases in URBC count, 24hUP excretion, and SCr level (P<0.05) and a significant increase in eGFR (P<0.05); compared with the control group, the treatment group had significantly higher decreases in URBC count, 24hUP excretion, and SCr level and a significantly higher increase in eGFR (P<0.05 or P<0.01). Conclusion YNBAP has good clinical efficacy in IgA nephropathy patients with yin-deficiency and blood-stasis syndrome and is suitable for those with mild or moderate proteinuria and early- or middle-stage renal impairment.