Objective To investigate the efficacy and safety of Venetoclax combined with Azacitidine in the treatment of high-risk myelodysplastic syndrome.Methods A total of 56 patients with high-risk myelodysplastic syndrome were enrolled from June 2019 to June 2022 in the Second Affiliated Hospital of Qiqihar Medical University.The patients were divided into a control group(n=30)and a study group(n=26)by simple random sampling.The control group received Azacitidine chemotherapy.The study group received Venetoclax combined with Azacitidine chemotherapy.The efficacy,adverse reactions,lactate dehydrogenase,β2 mi-croglobulin,and folic acid were compared between the two groups.Results The overall response rate in the study group was higher than that in the control group(P<0.05).The was no significant difference in the total incidence of adverse reactions between the two groups(P>0.05).After treatment,the serum levels of lactate dehydrogenase,β2 microglobulin and folic acid in the study group were all lower than those in the control group(P<0.05).Conclusion Venetoclax combined with Azacitidine can improve the thera-peutic effect and safety on high-risk myelodysplastic syndrome.