Objective To investigate the effect of traditional Chinese medicine decoction combined with levocetirizine in the treatment of chronic urticaria. Methods A total of 110 patients with chronic urticaria who were treated in Wuhan Jiangxia District Zhifang Street Community Health Service Center from January to April 2024 were randomly divided into control group and observation group, with 55 patients in each group. The control group was treated with levocetirizine, and the observation group was treated with traditional Chinese medicine decoction on the basis of the control group. The clinical efficacy, symptom score, inflammatory factors [high-sensitivity C-reactive protein (hs-CRP), interleukin-10 (IL-10), tumor necrosis factor-α (TNF-α)], immune factors [immunoglobulin E (IgE), interferon-γ (IFN-γ)] were compared between the two groups. Results The total effective rate of treatment in the observation group was 96.36%, which was higher than 78.18% in the control group (P <0.05). After treatment, the symptom scores of the observation group were lower than those of the control group (P <0.05). After treatment, the levels of hs-CRP, IL-10 and TNF-α in the observation group were lower than those in the control group (P <0.05). After treatment, the level of IgE in the observation group was lower than that in the control group, and the level of IFN-γ was higher than that in the control group (P <0.05). Conclusion Traditional Chinese medicine decoction combined with levocetirizine has a good effect in the treatment of chronic urticaria, which is helpful to improve clinical symptoms, reduce inflammatory reaction and correct the immune disorder of the body