Abstract: Objective:To observe the clinical efficacy of the immunosuppressant hydroxychloroquine combined with aspirin and low molecular weight heparin in the treatment of recurrent spontaneous abortion (RSA) in patients with antiphospholipid syndrome(APS).Methods:A total of 65 patients with APS-associated RSA admitted to RSA Clinic of Yulin Maternal and Child Health Hospital, Guangxi Zhuang Autonomous Region from January 2022 to December 2022 were collected, and the patients were divided into treatment and control groups using the random number table method.30 patients in the control group were given aspirin combined with low molecular weight heparin routinely, while 35 patients in the treatment group were given hydroxychloroquine in addition to the treatment used in the control group.The serum sex hormone levelsserum human chorionic gonadotropin(β-HCG), progesterone (P), estradiolo (E2), coagulation function adenosine diphosphate (ADP), D-dimer, uterine artery indexes pulsatility index (PI)、resistance index (RI), serum anticardiolipin antibodies (aCL), anti-β2 glycoprotein I antibodies(anti-β2GPI Ab), lupus anticoagulant(LAC), treatment outcomes, and the occurrence of adverse reactions of the patients were compared before and after treatment in the two groups.Results:After 12 weeks of gestation, serum E2, P and β-HCG levels increased in the treatment group compared with the control group(P< 0.05); ADP, D-dimer, uterine artery PI and RI decreased in the treatment group compared with the control group; aCL, anti-β2GPI Ab and LAC conversion rates were higher in the treatment group than in the control group; 26 cases were cured and 8 cases improved in the treatment group, with a total effective rate of 97.14%; 13 cases were cured and 11 cases improved in the control group, with a total effective rate of 80.00%(P< 0.05); the occurrence of adverse reactions in the treatment group was significantly lower than that in the control group(P< 0.05).Conclusion:The addition of hydroxychloroquine to the treatment of patients with APS-associated RSA on the basis of low molecular weight heparin combined with aspirin can more effectively reduce the occurrence rate of abortion in patients, which is worthy of further clinical promotion and application.