Objective  To discuss the effect of kidney-supplementing blood-quickening decoction combined with alprostadil on hemorheology and renal function in elderly patients with diabetic nephropathy (DN). Methods  From January 2017 to January 2019, 160 elderly patients with DN in our hospital were selected, and they were divided into control group and observation group according to the random number table, 80 patients in each group. The control group were treated with alprostadil, the observation group were treated with kidneysupplementing bloodquickening decoction on the basis. The effects of blood glucose control [fasting blood glucose (FBG), glycosylated hemoglobin (HbAlc), 2 hours postprandial blood glucose (2hPBG)], hemorheology [platelet aggregation rate (PAR) and low shear, mid-shear, high shear whole blood viscosity (BV)], renal function [Scr,BUN, 24 hours urine protein quantification (24hUPRO)], therapeutic efficacy and adverse reactions were compared between the two groups. Results  The FBG, HbAlc, 2hPBG, Scr, BUN, 24hUPRO, PAR and low, mid, high BV in control group and observation group after treatment were significantly lower than those before treatment, the FBG, HbAlc, 2hPBG, Scr, BUN, 24hUPRO, PAR and low, mid, high BV in observation group after treatment were significantly lower than those in control group, the difference was statistically significant (P<0.05). The effective rate in observation group was significantly higher than that in control group, the difference was statistically significant (P<0.05). There was no significant difference in the incidence of adverse reactions between control group and observation group (P>0.05). Conclusions  Kidney-supplementing blood-quickening decoction combined with alprostadil can effectively improve the blood sugar control effect, hemorheology and renal function of elderly patients with DN, it is helpful to improve the therapeutic effect, and it has the good safety, it's worth for further clinical promotion.