To analyze the effect of Wentong scraping for treating patients with primary dysmenorrhea symptoms of cold coagulation and blood stasis type, and to study its influence on the serum prostaglandin F2 alpha and prostaglandin E2 levels of the patients. Methods: From April 2022 to April 2023, 90 patients with primary dysmenorrhea were selected as the research subjects. These patients were divided into three groups (30 cases in each group) according to a completely randomized design program. The patients in group A received routine western medicine treatment during menstruation, including oral ibuprofen controlledrelease capsule. The patients in group B received Wentong scraping treatment alone after menstruation. And the patients in group C received routine western medicine combined with Wentong scraping treatment. The clinical efficacy, the traditional Chinese medicine (TCM) syndrome score, the scores of visual analogue scale (VAS) and COX menstrual symptom scale (CMSS), the levels of PGF2α and PGE2 and the duration of abdominal pain of the patients were compared among the three groups. Results: After treatment, the total clinical effective rate of the patients in group A (63.3%), in group B (83.3%) and in group C (90.0%) had increased gradually. The TCM syndrome scores of abdominal cold and pain, the limbs chilly and the lumbosacral ache of the patients in the three groups after treatment had decreased significantly, and which of the patients in group C and in group B were significantly lower than those of the patients in group A. The VAS and CMSS scores of the patients in the three groups after treatment had decreased significantly, and which of the patients in group C (3.60±0.77 points and 17.16±5.08 points) were significantly lower than those (4.67±0.83 points and 26.45±6.17 points) of the patients in group A and those (4.47±0.84 points and 23.60±5.94 points) of the patients in group B. The PGF2α level and PGF2α/PGE2 ratio of the patients in the three groups after treatment had decreased significantly, while the PGE2 level of the patients in the three groups after treatment had increased significantly, and the changes of which of the patients in group C and in group B were significantly more than those of the patients in group A. The duration of abdominal pain of the patients in the three groups after treatment had decreased significantly, and which of the patients in group A (2.03±1.01d), in group B (1.56±0.79d) and in group C (1.14±0.55d) had decreased gradually (all P＜0.05). Conclusion: The western medicine combined with Wentong scraping for treating the patients with primary dysmenorrhea symptoms of cold coagulation and blood stasis type can alleviate their dysmenorrhea symptoms effectively, decrease their serum PGF2α and PGE2 levels, and improve their clinical efficacy.