OBJECTIVES: To investigate the effect of Shenfu injection combined with face mask mechanical ventilation (FMMV) on microcirculation in patients with acute cardiogenic pulmonary edema. METHODS: Sixty-four patients with acute cardiogenic pulmonary edema from March 2013 to March 2017 were randomly divided into control group (n=32) and Shenfu group (n=32). The control group wastreated according to the relevant guidelines for the treatment of standardized drugs and the FMMV treatment: the Shenfu group was treated with Shenfu injection on the basis of the treatment plan of the control group. One week (1w) was used as a course of treatment. After the end of one course of treatment, the central venous oxygen saturation was observed before treatment, after 6 hours (6h), after 24 hours (24h), and after 1 week (1w). The following were measured degree (ScvO2), oxygen and index (OI, PaO2/FiO2), arterial blood lactate (Lac) clearance, central venous pressure (CVP), mean arterial pressure (MAP), and the incidence of adverse drug reactions. RESULTS: ScvO2, OI, CVP and MAP were better in the two groups after 6h, 24h and 1w than before treatment (P<0.05). The Lac clearance rate after treatment for 24h and 1w was higher than that before treatment. The ScvO2, OI and MAP of the patients in the Shenfu group were significantly higher than those in the control group at 6h, 24h and 1w (P<0.05). The Lac clearance rate after 24h and 1w treatment was higher than that in the control group. The CVP of Shenfu group was significantly lower than that of the control group after 6h, 24h and 1w (P<0.05). No adverse reactions occurred during the treatment of all patients with the ginseng injection. Conclusion: Shenfu injection combined with face mask mechanical ventilation (FMMV) can significantly improve oxygen metabolism, increase tissue perfusion, and improve microcirculation in patients with acute cardiogenic pulmonary edema (Am J Transl Med 2018. 2:120-124).