Objective To analyze the clinical effect of Maqin Xiaoke Granules on acute cough. Methods A total of 80 patients with acute cough admitted in the Donghua Donghua Hospital from March 2020 to March 2021 were selected as the research subjects for a retrospective analysis. According to different therapeutic methods, they were divided into a conventional group (n=40) and a treatment group (n=40). The patients in the conventional group were treated with Compound Pseudoephedrine Hydrochloride Solution, and the patients in the treatment group were treated with Maqin Xiaoke Granules. The treatment effect, traditional Chinese medicine syndrome score, pulmonary function, number of coughs within 2 min and the occurrence of adverse reactions were compared between the two groups. Results The total effectiveness rate of treatment in the treatment group was 85.00%, higher than that in the conventional group accounting for 60.00%, and the difference was statistically significant (P<0.05). There were no significant differences in traditional Chinese medicine syndrome scores of cough, expectoration, fever, asthma, daytime cough and night cough before treatment between the two groups (P>0.05). After treatment, the traditional Chinese medicine syndrome scores of cough, expectoration, fever, asthma, daytime cough and night cough in the treatment group after treatment were lower than those in the conventional group, and the traditional Chinese medicine syndrome scores of cough, expectoration,fever, asthma, daytime cough and night cough in the two groups after treatment were lower than those in the same group before treatment, and the differences were statistically significant (P<0.05). There were no significant differences in the levels of forced vital capacity (FVC), forced expiratory volume in one second (FEV1) or peak expiratory flow (PEF) between the two groups before treatment (P>0.05). The levels of FVC, FEV1, and PEF after treatment in the treatment group were higher than those in the conventional group, and the levels of FVC, FEV1, and PEF in the two groups after treatment were higher than those before treatment, and the differences were statistically significant (P<0.05). The number of coughs within 2 min in the two groups before treatment did not show statistical significance (P＞0.05). After treatment, the number of coughs within 2 min in the treatment group was less than that in the conventional group, and the number of coughs in the two groups within 2 min after treatment was less than that before treatment in the same group,and the differences were statistically significant (P＜0.05). The total incidence of adverse reactions in the treatment group was 7.50%, which was not significantly different from that in the conventional group, 12.50% (P＞0.05). Conclusion The application of Maqin Xiaoke Granules has a remarkable therapeutic effect. It can effectively promote the disappearance of related symptoms, reduce the traditional Chinese medicine syndrome score, and play a good role in protecting and improving lung function, and reducing the number of coughs in high safety. There are few adverse reactions after medication, which is of great significance in the clinical treatment of acute cough, and has high clinical therapeutic value. It is recommended to be adopted and promoted.