With the acceleration of urbanization in China, historical and cultural districts in ancient cities have experienced rapid development under the promotion of various policies, gradually forming a homogenized development model for ancient cities. The rapid development has brought about environmental pollution and distortion in the protection of ancient city culture, making the contradiction between ancient city protection and renewal planning increasingly prominent. This study extends the theory and techniques of spatial suturing to the macro scale of historical districts in ancient cities, exploring the suturing effects and practical applications of ancient city design planning at the level of street and alley spaces and historical contexts. It aims to promote the sustainable development of historical and cultural ancient cities, and achieve the coordinated development of cultural heritage protection and socio-economic progress.