Objective To explore the characteristics and compatibility of Chaihu Guizhi Ganjiang decoction based on case analyses.Methods The ancient and modern cases of Chaihu Guizhi Ganjiang decoction were searched in Hantang traditional Chinese medicine literature database and SinoMed. The main symptoms and drug use of each case in the literatures were counted by frequency, and the characteristics of prescriptions and syndromes and the law of drug compatibility were analyzed by factor analysis and hierarchical clustering.Results A total of 236 cases were collected, including 9 ancient cases and 227 modern cases. Factor analysis of common symptom variables showed that the symptoms of Chaihu Guizhi Ganjiang decoction could be divided into 4 categories: gallbladder depression and Qi stagnation symptoms, symptoms of spleen deficiency and digestive tract, abnormal body fluid metabolism and Yang deficiency symptoms. The results of hierarchical clustering showed that the main pathogenesis of decoction syndrome was Shaoyang stagnation, bile and stomach loss and dampness, Shaoyang stagnation and disorder between liver and spleen, with Yang Qi deficiency. In terms of drug use, the original prescription of Chaihu Guizhi Ganjiang decoction had the highest frequency of use. At the same time, it was more compatible with drugs for strengthening the spleen, harmonizing the stomach, nourishing blood and calming the nerves. The results of hierarchical clustering of drug variables showed that the original drugs of Chaihu Guizhi Ganjiang decoction had an absolute advantage in drug use and were grouped into an independent category. Tangerine peel, Codonopsis pilosula and Pinellia ternata were grouped together to play the role of invigorating deficiency, reducing stomach and eliminating dampness. Poria cocos, Alisma orientalis, Atractylodes macrocephala, Radix Paeoniae Alba, Angelica sinensis and keel were grouped together to supplement Qi and nourish blood, and strengthen spleen and dampness.Conclusion The main syndromes of Chaihu Guizhi Ganjiang decoction are characterized by stagnation of Shaoyang, imbalance of spleen and stomach and immobility of body fluid and Qi. Clinically, there are subtle differences between Shaoyang and disharmony of stomach Qi and Shaoyang and deficiency of Taiyin, so the medication should be adjusted flexibly.