Introduction: Fresh Phyllanthus emblica (P. emblica) known as Indian gooseberry is considered to be an effective treatment for relieving xerostomia during radiotherapy. The aim of this study was to prospectively evaluate the efficacy and safety of P. emblica spray, for treating postoperative xerostomia. Methods: This was a prospective, single blind, two-arm parallel randomized controlled trial. Sixty-four patients with xerostomia after general anesthesia for gynecologic tracheal intubation, were randomly assigned to either the intervention or control group, with a 1:1 ratio using random number tables. Participants were recruited from the Gynecology Department of the Second Affiliated Hospital of Guangzhou University of Chinese Medicine. Subjects in the intervention group were treated with P. emblica spray, while those in the control group were provided with a warm water spray. All subjects received spray treatment: once per 15 min within 6 h after operation. Results: 64 participants were enrolled, 6 were lost to follow-up, the remaining 58 were available for analysis. Mean age was 40.05 +/- 10.35 and all were female. There were no statistically significant differences between the two groups in terms of age, body mass index, allergy history, surgical history, TCM diagnosis, grade, syndrome type, or duration of anesthesia and preoperative water fasting. After six hours of treatment, mean salivary flow rate scores at 3-h to 6-h significantly increased in the intervention group by 0.21 +/- 0.14-0.29 +/- 0.18 and by 0.14 +/- 0.11-0.20 +/- 0.12 in the controls (p = 0.028). Similar improvements were observed in the intervention group, compared to the control group, with respect to the grade of oral mucosa moisture at 1, 3, 4, 5 and 6 h (p = 0.034). Conclusions: The use of P. emblica spray appeared to be superior to warm water spray for treating postoperative xerostomia.