Objective To study the clinical efficacy and safety of ginseng decoction in treatment of severe pneumonia in elderly patients.Methods 100 elderly patients with severe pneumonia treated in Department of Traditional Chinese Medicine,Renji Hospital Affiliated to Medical College of Shanghai Jiaotong University from April 2022 to June 2023 were enrolled.They were divided into control group and experimental group according to random number method,with 50 cases in each group.The control group was given routine treatment,and the experimental group was given ginseng decoction on the basis of routine treat-ment.Then,the disappearance time of symptoms(including fever,cough,fatigue,anorexia,and asthma),changes of labo-ratory indexes(WBC,NA,L,AST,LDH,CRP),the absorption of lung lesions on CT images,and the length of hospital stay after treatment were compared between the two groups.Results After treatment,the disappearance time of symptoms such as fever,cough,fatigue,anorexia,and asthma in the experimental group was significantly shorter than that in the control group,and the difference was statistically significant(P<0.05).The laboratory indexes of the two groups were improved.Among these laboratory indexes,the levels of L,LDH and CRP in the experimental group were significantly improved com-pared with the control group,and the differences were statistically significant(P<0.05),while the other indexes were not sta-tistically significant(P>0.05).There was statistical significance in absorption of lung lesions between the two groups after treatment(P<0.05).The length of hospital stay of the experimental group was(12.14±2.01)d,and that of the control group was(13.10±2.47)d,and the difference was statistically significant(P<0.05).During the administration of ginseng decoction,mild nausea and diarrhea occurred in 3 cases of 50 patients.None of the patients stopped taking the drug and no liver or kidney function damage was observed.Conclusion Ginseng decoction can effectively assist in improving symptoms of eld-erly patients with severe pneumonia,reducing inflammatory indexes,promoting the absorption of lung lesions,and has good safety.It is worth promoting and researching in a large-scale population.