Objective To comparison of the effect of blue paste and calcium hydroxide glycerol paste in patients with onetime root canal therapy. Methods 95 patients (109 teeth) received root canal therapy from january 2016 to october 2018 were included in the study. 50 cases (58 teeth) in the observation group and 45 cases (51 teeth) in the control group were divided by random number table method. The postoperative visual analogue scale (VAS), incidence and success rate of emergency response were compared.Results The VAS scores of the observation group at after operation 1, 3 and 7 days were 402±064 scores, 294±050 scores and 165±034 scores, respectively, which were significantly lower than those in the control group 483±071 scores, 353±059 scores and 193±039 scores (P＜0.05). The incidence of acute reaction in the observation group was 600% at after operation 7d, which was significantly lower than those in the control group 2222% (P＜0.05). The success rate of operation in observation group was 9800% at after operation 6 months, which was significantly higher than those in the control group 8444% (P＜0.05).Conclusion Compared with calcium hydroxide glycerin paste, the effect of Bilan paste in onetime root canal therapy is more significant, which can effectively reduce pain and emergency response after operation, and ensure longterm filling effect.