Objective To analyze the effect of Yishen Qushi decoction combined with finasteride tablets on hair loss improvement time in the treatment of male androgenetic alopecia. Methods A total of 300 male patients with androgenetic alopecia admitted to the Department of Dermatology, Beijing Jingcheng Skin Hospital from February 2024 to February 2025 were selected as the research subjects, and they were divided into the control group and the study group by the random number table method, with 150 patients in each group. The control group was treated with finasteride tablets, and the study group was treated with Yishen Qushi decoction on the basis of the control group. The clinical efficacy, scalp environment improvement, hair loss improvement time, hair loss improvement degree, new hair growth and adverse reaction rate were compared between the two groups. Results The total effective rate of treatment in the study group was 94.67%, which was higher than 86.67% in the control group (P<0.05). The scores of dandruff, oiliness and pruritus in the study group after treatment were lower than those in the control group (P<0.05). The hair loss improvement time of the study group was shorter than that of the control group (P<0.05). The scores of hair loss improvement degree and new hair growth in the study group after treatment were better than those in the control group (P <0.05). There was no statistically significant difference in the incidence of adverse reactions between the two groups (P >0.05). Conclusion The application of Yishen Qushi decoction combined with finasteride tablets in the treatment of male androgenetic alopecia can effectively improve the clinical effect, shorten the hair loss improvement time, optimize the scalp environment, promote new hair growth, and does not increase adverse reactions.