Objective: To analyze the therapeutic effect of Xuebijing + antimicrobials in intensive care unit (ICU) patients with severe pneumonia. Methods: 60 ICU patients with severe pneumonia from June 2021 to June 2023 were selected and divided by the random number table method, with 30 cases in each group. The observation group received Xuebijing + antimicrobial treatment, while the control group received only antimicrobial treatment. The differences in rehabilitation indexes, test indexes, and inflammation indexes were compared between the two groups. Results: Mechanical ventilation time, fever reduction time, cough relief time, and hospitalization time of the observation group were significantly shorter than those of the control group (P < 0.05); C-reactive protein, procalcitonin, and white blood cell count of the observation group were significantly lower than those of the control group (P < 0.05); interleukin-6 and tumor necrosis factor-α of the observation group were significantly lower than those of the control group (P < 0.05). Conclusion: The treatment of severe pneumonia patients in ICU with Xuebijing + antibacterial drugs can reduce inflammation, enhance immune function, shorten the pneumonia recovery time, and reduce the adverse reactions of severe pneumonia.