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Objective To investigate the efficacy and safety of Venetoclax combined with Azacitidine in the treatment of high-risk myelodysplastic syndrome. Methods A total of 56 patients with high-risk myelodysplastic syndrome were enrolled from June 2019 to June 2022 in the Second Affiliated Hospital of Qiqihar Medical University.The patients were divided into a control group(n=30) and a study group(n=26) by simple random sampling.The control group received Azacitidine chemotherapy.The study group received Venetoclax combined with Azacitidine chemotherapy.The efficacy, adverse reactions, lactate dehydrogenase, β2 microglobulin, and folic acid were compared between the two groups. Results The overall response rate in the study group was higher than that in the control group(P0.05).After treatment, the serum levels of lactate dehydrogenase, β2 microglobulin and folic acid in the study group were all lower than those in the control group(P