Objective To investigate the association between traditional Chinese medicine (TCM) syndrome pattern and clinical features in patients with Hashimotos thyroiditis comorbid with autoimmune gastritis. Methods A retrospective cross-sectional study was conducted among 56 patients with Hashimotos thyroiditis comorbid with autoimmune gastritis who attended Jiading Hospital of Traditional Chinese Medicine from May 2018 to October 2023. Related data were collected, including the information obtained by four diagnostic methods (clinical symptoms,tongue manifestation, and pulse manifestation), thyroid function (free triiodothyronine, free thyroxine, and thyroid stimulating hormone), and antibodies ［thyroid peroxidase antibody （TPOAb）and thyroglobulin antibody（TGAb）］. The methods of factor analysis and cluster analysis were used to investigate the distribution and types of TCM syndromes in Hashimotos thyroiditis comorbid with autoimmune gastritis, as well as the association of each syndrome type with other comorbidities, thyroid function, and antibodies. Results Among the 56 patients, there were 47 female patients and 9 male patients. The factor analysis and the cluster analysis obtained the following four syndrome types:deficiency of both Qi and Yin, Qi-stagnation syndrome of liver and stomach,liver depression transforming into fire, and spleen-stomach damp-heat syndrome, and there were 21 patients with deficiency of both Qi and Yin, 17 with Qi-stagnation syndrome of liver and stomach,15 with liver depression transforming into fire,and 3 with spleen-stomach damp-heat syndrome.There was no significant difference in thyroid function between the patients with different syndrome types (P>0.05). The patients with liver depression transforming into fire tended to have an increase in TPOAb antibodies(P<0.05), and those with Qi-stagnation syndrome of liver and stomach tended to have an increase in TGAb antibodies(P<0.05). The patients with deficiency of both Qi and Yin often had the comorbidity of thyroid nodules(P<0.05). Conclusion Qi-stagnation syndrome of liver and stomach, liver depression transforming into fire, and deficiency of both Qi and Yin are the main TCM syndrome types in patients with Hashimotos thyroiditis comorbid with autoimmune gastritis.