To investigate the effects of Pulsatilla saponin B4 on therapeutic effect, serum inflammatory and immune factors in dairy cows with clinical mastitis, 12 healthy dairy cows were selected as the control group, and 36 clinical mastitis cows were selected as the test group and were randomly divided into low, middle and high dose group. Cows in test group were administered with Pulsatilla saponin B4 injection (with doses of 0.025, 0.05, 0.1 mL·kg-1, respectively) through cervical intramuscular injection once a day for 6 days, whereas no medicine was administered in the control group. The effective and cure rates of cows in the test group were recorded, venous blood samples were collected (any day in the control group and the 1st, 3rd, 5th, 7th day in the test group) to measure serum inflammatory and immune factors, as well as milk in the infected quarters on the 1st, 7th, 12th day in the test group to conduct somatic cells count (SCC) and pathogenic microorganism isolation and identification during this experiment. Cows were observed till the 12th day and the therapeutic efficiency was recorded. It was shown that the clinical cure rate and effective rates of low, middle and high dose group were 75.00%, 75.00%, 91.67% and 100%, 100%, 100%, respectively, and the average cure time was 6.33, 6.11, 6.91 d, respectively. The Pulsatilla saponin B4 could significantly (P<0.05) attenuate SCC. Before treatment, 34 out of 36 milk samples were positive with pathogenic microorganism, indicating a detection rate of 94.44%, which mainly consisted of mycoplasma, cocci and Escherichia coli. After treatment, the total negative rate was 52.94%, among which, the negative rate of Bacilli, Staphylococcus chromogenes, Staphylococcus haemolyticus and Escherichia coli were 100%, while the negative rates of mycoplasma, Staphylococcus aureus, Staphylococcus epidermidis and coccus were 69.23%, 60.00%, 50.00% and 33.33%, respectively. Besides, Pulsatilla saponin B4 could significantly (P<0.05) promote the recovery of inflammatory factors CRP, SAA, HP, IL-1α, IL-1β, IL-2, IL-6, IL-8, TNF-α and immune factors IgA, IgD, IgE, IgG, IgM to normal levels.