Objective To explore the effects of recombinant human thrombopoietin (rhTPO) combined with allogeneic hematopoietic stem cell transplantation (allo-HSCT) on platelet recovery in patients with acute myeloid leukemia (AML). Methods A total of 74 patients with AML admitted to the hospital were enrolled as the research objects from January 2020 to December 2021. They were randomly divided into control group (37 cases, allo-HSCT) and observation group (37 cases, rhTPO combined with allo-HSCT). After treatment, platelet reconstruction and recovery time, coagulation function indexes ［prothrombin time (PT), fibrinogen (FIB), activated partial thrombopastin time (APTT)］, inflammatory factors ［procalcitonin (PCT), C-reactive protein (CRP), interleukin-6 (IL-6)］ and vascular indexes ［vascular endothelial growth factor (VEGF), vascular endothelial growth factor C (VEGF-C)］, and occurrence of adverse reactions during treatment were compared between the two groups. Results After treatment, platelet reconstruction and recovery time in observation group were shorter than those in control group (P<0.05). The levels of APTT and PT were lower in observation group than control group, while FIB was higher in observation group (P<0.05). The levels of PCT, CRP and IL-6 were lower in observation group than control group (P<0.05), while levels of VEGF and VEGF-C were higher in observation group (P<0.05). During treatment, total incidence of adverse reactions was lower in control group than observation group (P>0.05). Conclusion The rhTPO combined with hematopoietic stem cell transplantation can shorten platelet reconstruction and recovery time, enhance coagulation function, relieve inflammation response and improve blood supply of hematopoietic micro-environment in AML, with good safety