Objective: To investigate the clinical efficacy, mechanism of action of traditional Chinese and Western medicine, and reasonable treatment regimen of Shenrongbian pills in the treatment of impotence and premature ejaculation caused by kidney-Yang deficiency. Methods: A total of 160 patients with impotence and premature ejaculation caused by kidney-Yang deficiency admitted to our hospital from January 2023 to January 2024 were randomly divided into an observation group (80 cases) and a control group (80 cases). The observation group was treated with Shenrongbian pills; the control group was treated with sildenafil citrate tablets combined with dapoxetine. The International Index of Erectile Function (IIEF-5), intravaginal ejaculatory latency time (IELT), traditional Chinese medicine kidney-Yang deficiency syndrome score, overall clinical response rate, and safety were compared between the two groups before and after treatment. Results: There was no significant difference in the IIEF-5 scores and IELT between the two groups before treatment (P > 0.05). After 3 months and 6 months of treatment, both indicators improved significantly in both groups (P < 0.05), and the improvement in the observation group was more significant than that in the control group, with a more pronounced difference at 6 months (P < 0.001); there was no significant difference in the total traditional Chinese medicine syndrome scores between the two groups before treatment (P > 0.05). After 3 and 6 months of treatment, the traditional Chinese medicine (TCM) syndrome scores in the observation group were significantly lower than those in the control group (P < 0.05), and continued to decrease with prolonged treatment duration. The improvement in scores in the control group was not significant (P > 0.05). After 6 months of treatment, the overall response rate in the observation group was 93.75%, significantly higher than the 81.25% in the control group (χ² = 5.714, P = 0.017 < 0.05). In the observation group, there was 1 case of dizziness and 2 cases of gastric discomfort, with an adverse reaction rate of 3.75%. In the control group, there were 4 cases of headache, 2 cases of facial flushing, and 1 case of abnormal vision, with an incidence rate of 12.5%. Conclusion: Shenrongbian pill, through mechanisms such as warming and tonifying the kidney-Yang, harmonizing Yin and Yang, improving microcirculation, and regulating endocrine function, can significantly improve sexual function and systemic symptoms in patients with impotence and premature ejaculation due to kidney-Yang deficiency. It is highly safe, with a recommended treatment duration of 3–6 months, and its efficacy shows an increasing trend with prolonged treatment.