Objective To explore the clinical effect of traditional Chinese medicine decoction combined with acupuncture and moxibustion in the treatment of recurrent alopecia areata with liver and kidney deficiency. Methods From April 2021 to January 2023, 60 patients with recurrent alopecia areata of liver and kidney deficiency type admitted to the affiliated hospital of our university were selected as the research objects and randomly divided into control group and study group, with 30 patients in each group. The control group was treated with traditional Chinese medicine decoction, and the study group was treated with traditional Chinese medicine decoction combined with acupuncture and moxibustion. The clinical efficacy, skin lesion hair growth, inflammatory factor levels, adverse reactions and recurrence were compared between the two groups. Results The total effective rate of treatment in the study group was 96.67%, which was higher than 73.33% in the control group (P<0.05). The growth time and blackening time of vellus hair in the study group were shorter than those in the control group, and the number density of final hair was higher than that in the control group (P<0.05). After treatment, the levels of TNF-α and IL-10 in the study group were lower than those in the control group (P<0.05). The incidence of adverse reactions in the study group was 0, which was lower than 16.67% in the control group (P<0.05). The recurrence rate of alopecia areata in the seudy group was 10.00%, which was lower than 46.67% in the control group (P<0.05). Conclusion Traditional Chinese medicine decoction combined with acupuncture and moxibustion has a good clinical effect in the treatment of recurrent alopecia areata of liver and kidney deficiency type, which can improve the therapeutic effect, promote the growth of skin lesions and hair, effectively inhibit the inflammatory reaction, and the incidence of adverse reactions and recurrence rate are low after treatment