Objective <p>To observe the clinical efficacy of herb cake-insulated moxibustion at Shenque (CV8) in treating primary dysmenorrhea (PD) of cold-induced blood stasis pattern, and its influence on serum inflammatory factors.</p> Methods <p>A total of 60 patients with PD of cold-induced blood stasis pattern were randomly divided into an herb cake-insulated moxibustion group and a medication group by the random number table method, with 30 cases in each group. The medication group was treated with oral ibuprofen sustained-release capsules, initiated 3 d before menstruation and continued until the end of the menstrual period. The herb cake-insulated moxibustion group received herb cake-insulated moxibustion at Shenque (CV8), once daily starting 3 d before menstruation until menstruation ended. One menstrual cycle was defined as one treatment course, and both groups received treatment for 3 courses in total. The scores of visual analog scale (VAS) and traditional Chinese medicine symptoms were observed and recorded before and after treatment. In both groups, changes in the serum levels of interleukin (IL)-6, prostaglandin (PG) F_2α, PGE₂, and β-endorphin (β-EP) were determined before and after treatment. The clinical efficacy was evaluated.</p> Results <p>The total effective rate was 93.3% in the herb cake-insulated moxibustion group and 80.0% in the medication group, showing no statistically significant difference between the two groups (<i>P</i>&gt;0.05). After treatment, the VAS and traditional Chinese medicine symptom scores decreased significantly in both groups compared with baseline (<i>P</i>&lt;0.05), and the herb cake-insulated moxibustion group showed lower scores than the medication group (<i>P</i>&lt;0.05). The serum levels of IL-6 and PGF_2α were reduced in the herb cake-insulated moxibustion group after treatment (<i>P</i>&lt;0.05) and were lower than those in the medication group (<i>P</i>&lt;0.05). The herb cake-insulated moxibustion group also showed increased levels of PGE₂ and β-EP after treatment (<i>P</i>&lt;0.05), which were higher than those in the medication group (<i>P</i>&lt;0.05).</p> Conclusion <p>Herb cake-insulated moxibustion at Shenque (CV8) can alleviate pain and relieve clinical symptoms in patients with PD of cold-induced blood stasis pattern, and can downregulate serum IL-6 and PGF_2α levels while upregulating PGE2 and β-EP contents.</p>