Objective To explore the clinical efficacy of compound salvia miltiorrhiza injection and urokinase combined with warfarin in prevention of deep vein thrombosis of lower extremities after hip joint replacement surgery. Method Fifty-six patients undergoing hip replacement surgery from January 2016 to January 2018 in our hospital were selected as study subjects and randomly divided into control group (28 cases) and observation group (28 cases). The control group was given warfarin and urokinase anticoagulation 12 hours after the operation, and the observation group was treated with compound salvia miltiorrhiza injection on the basis of the control group. Both groups of patients were treated for 14 consecutive days. The incidence of DVT in the lower extremities, changes in the circumference of the lower extremities, changes in the levels of serum D-dimer, CRP, IL-6 and adverse events were observed in both groups. Results The incidence of deep venous thrombosis in the observation group was lower than that in the control group (P < 0.05). There was no significant difference in thigh circumference difference and calf circumference difference between the two groups before treatment (P > 0.05). After treatment, the difference of thigh circumference and calf circumference between the two groups decreased, and the differences of thigh circumference and calf circumference in the observation group were lower than those in the control group (P < 0.05). The serum D-D, CRP and IL-6 levels were measured on the 1st day, 3rd days and 7th days after treatment: 1. There were differences in serum D-D, CRP and IL-6 levels at different time points (P < 0.05); 2. There were differences in serum D-D, CRP and IL-6 levels between the observation group and the control group (P < 0.05); 3. There were differences in trends of serum D-D, CRP and IL-6 levels between the observation group and the control group (P < 0.05). Conclusions Compound salvia miltiorrhiza injection and urokinase combined with warfarin can help prevent deep vein thrombosis of lower extremities after hip arthroplasty and help improve the hypercoagulable state of blood. There was certain clinical application value.