Objective: To evaluate the efficiency and safety of sponge bathing in combination with different Chinese herbal preparation in patients with hyperthermia. Methods: Eighty-eight patients (>= 18 years) treated in the intensive care unit (ICU) with a fever of > 39.1 degrees C received sponge bathing in combination with a randomized TCM: 1) ordinary herbal lotion (n= 29); 2) instant herbal powder (n= 29); and 3) ethanol-immersed herbal lotion (n= 30). Outcomes included the relative densities of different herbal lotion, time of the preparation for the lotion, and changes in axillary temperature (monitored every 30 minutes for 2 hours). In addition, allergic reaction, skin cracking, and complaints of discomfort were monitored. Results: Body temperature decreased in all treatment groups. However, no significant differences in total cooling effective rates were found among three groups. There was no significant difference in relative drug densities (p> 0.05). Ethanol-immersed herbal sponge bathing increased signs of discomfort (P<0.01). Conclusions: Sponge bathing in combination with ordinary herbal lotion, instant herbal powder or ethanol-immersed herbal lotion equally reduced body temperature. Considering the relative short preparation time, and fewer adverse effects, instant herbs powder should be considered the first antipyretic choice in hyperthermia patients.