Objective To prepare the berberine-Bletilla striata polysaccharide-carboxymethyl chitosan composite dressing (BBCCD) and evaluate its physical properties and efficacy. Methods The BBCCD was prepared by vacuum freeze-drying method. The optimum proportion was selected based on porosity, water absorption and air permeability. The microstructure of BBCCD was observed by scanning electron microscopy, the antibacterial activity was evaluated by antibacterial experiment, and the cytotoxicity was tested by cell counting kit 8 method. The blood samples of New Zealand rabbits were randomly divided into gauze group, gelatin sponge group and BBCCD group, and the coagulation effect of BBCCD was evaluated by in vitro coagulation experiment (n＝6). Seventy-two SD rats were randomly divided into gauze group, gelatin sponge group and BBCCD group, and the hemostatic time was evaluated by femoral vein, liver and tail-cut hemostasis experiments (n＝8). Fifty-four SD rats were randomly divided into control group, chitosan group and BBCCD group, and the wound repair effects of BBCCD were evaluated by wound healing rate (n＝6), detection of serum interleukin (IL)-1β, tumor necrosis factor α (TNF-α) and IL-10 (n＝4) and histopathological examination. Results The optimal volume ratio of 5% Bletilla striata polysaccharide to 5% carboxymethyl chitosan composite in BBCCD was 1∶3. BBCCD had a membranous sponge-like porous structure with no obvious toxicity. It could absorb wound exudate and had strong adhesion. The content of berberine was (52.39±0.87) mg/g. BBCCD had antibacterial effects on Staphylococcus aureus and Escherichia coli. The in vitro blood clotting index and the hemostatic time of femoral vein trauma, liver trauma and tail-cut in the BBCCD group were significantly better than those in the gelatin sponge group and gauze group (all P＜0.01). On the 3^rd, 5^th, 7^th and 14^th days, the wound healing rate of the BBCCD group was significantly higher than that of the chitosan group and control group (all P＜0.05). On the 7^th and 14^th days, the serum level of IL-10 in the BBCCD group was significantly increased and the serum levels of IL-1β and TNF-α were significantly decreased compared with the chitosan group and control group (all P＜0.05). The pathological results showed that BBCCD could promote the formation of granulation tissue and capillaries at the initial stage of wound healing, attenuate inflammatory response, and accelerate wound healing. Conclusion The prepared BBCCD has excellent antibacterial activity, hemostasis and wound healing effects with stable properties.