Objective To analyze the application of Xuebijing Injection and low molecular weight heparin calcium in the treatment of sepsis.Methods A total of 82 patients with sepsis who were treated at Lianyungang Second People's Hospital from November 2021 to November 2024 were selected. The patients were divided using the stratified random sampling method into the control group (treated with low molecular weight heparin calcium, n = 41) and the experimental group (treated with Xuebi Jing injection in combination with low molecular weight heparin calcium, n = 41). The efficacy, coagulation function [D-dimer (D-D), fibrinogen (FIB) ], thromboelastography (TEG) parameters [R time (reaction time), K time (clot formation time), α angle (α angle), MA value (maximum amplitude), CI value (coagulation index) ], inflammatory factors [procalcitonin (PCT), interleukin-6 (IL-6), C-reactive protein (CRP) ], T lymphocyte subsets (CD3⁺, CD4⁺, CD8⁺, CD4⁺/CD8⁺), sepsis-related organ failure assessment (SOFA score), mortality in emergency department sepsis (MEDS) score, and acute physiology and chronic health evaluation Ⅱ (APACHE Ⅱ score) were compared between the two groups.Results The total effective rate in the experimental group was higher than in the control group (P < 0.05). After treatment, the experimental group had lower D-D levels and higher FIB levels compared to the control group (P < 0.05). The changes in D-D and FIB levels before and after treatment were significantly greater in the experimental group than in the control group (P < 0.05). After treatment, the experimental group had shorter K time, and higher α angle, MA value, and CI value compared to the control group (P < 0.05). The changes in K time, α angle, MA value, and CI value before and after treatment were significantly greater in the experimental group than in the control group (P < 0.05). After treatment, the experimental group had lower PCT, IL-6, and CRP levels compared to the control group (P < 0.05). The changes in PCT, IL-6, and CRP levels before and after treatment were significantly greater in the experimental group than in the control group (P < 0.05). After treatment, the experimental group had higher CD3⁺, CD4⁺, and CD4⁺/CD8⁺ levels, and lower CD8⁺ levels compared to the control group (P < 0.05). The changes in CD3⁺, CD4⁺, CD8⁺, and CD4⁺/CD8⁺ levels before and after treatment were significantly greater in the experimental group than in the control group (P < 0.05). After treatment, the experimental group had lower SOFA, MEDS, and APACHE Ⅱ scores compared to the control group (P < 0.05). The changes in SOFA, MEDS, and APACHE Ⅱ scores before and after treatment were significantly greater in the experimental group than in the control group (P < 0.05).Conclusion The use of Xuebijing injection in combination with low molecular weight heparin calcium for the treatment of sepsis can effectively optimize the coagulation function of patients, improve the relevant indicators of thromboelastography, regulate the inflammatory response, and enhance the immune level. It significantly reduces the SOFA score, MEDS score and APACHE Ⅱ score, and has a good clinical application effect.