Background and aim: To investigate the effectiveness of Chinese herbal medicine topical therapy in the recovery of gastrointestinal function after abdominal surgery in a prospective multi-center randomized controlled trial. Methods: A total of 1029 patients fell into control group, coarse salt hot compress (CS) group, evodia hot compress (ECS) group and evodia hot compress plus electro-acupuncture (ECS & EA) group. The gastrointestinal function was evaluated and compared at different time points. Results: Statistically significant difference was observed on the time to first defecation (P < 0.05), and the longest time to first defecation was 95.3 +/- 44.8 h in CS group. The three experimental groups had shorter time to first passing flatus on Timepoint 5 (the fifth day after surgery) than control group (P < 0.05). More patients in ECS & EA group reported no abdominal distention than patients in CS group (89% vs. 80%; P < 0.05) on Timepoint 2 (the second day after surgery). 77.4% of control group complained no abdominal pain on Timepoint 2, which was the lowest, and there was no difference among the four groups on other timepoints (P > 0.05). The difference on nausea and vomiting was only found statistically significant among the four groups on Timepoint 3 (the third day after surgery) (P < 0.05). Conclusion: Chinese medicine topical therapy helps the recovery of the postoperative gastrointestinal function after abdominal surgery, which may be widely introduced to the clinical practice, and the measurements enrolled in our study are efficient in evaluating the efficacy of Chinese herbal therapy.