Objective To ascertain the safety and efficacy of Xuezhikang Capsule coupled with alixizumab in the treatment of dyslipidemia in patients with statin intolerant coronary heart disease. Methods A total of 102 subjects diagnosed with statin intolerant coronary heart disease who attending Binhai County People’s Hospital from January 2022 to December 2024 were prospectively enrolled and randomly assigned into two groups by the random number table method: control group (receiving alirocumab alone) and combination group (receiving Xuezhikang Capsule in addition to alixizumab), 51 cases in each group. TCM syndromes, blood lipid indexes, endothelial function parameters, and safety outcome were conducted between the two groups. Results After intervention, the levels of TCM syndromes, low density lipoprotein-cholesterol (LDL-C), triacylglycerol (TG), total cholesterol (TC), soluble intercellular adhesion molecule-1 (sICAM-1), asymmetric dimethylarginine (ADMA), and matrix metalloproteinase-9 (MMP-9) in the combination group were significantly lower than those in control group (all P＜0.05). The levels of high?density lipoprotein cholesterol (HDL-C) and calcitonin gene-related peptide (CGRP) were significantly higher than those in control group (all P＜0.05). The incidence of adverse events was 9.80% in the combination group and 17.65% in the control group, with no statistically significant difference between the two groups (P＞ 0.05). Conclusion Xuezhikang Capsule coupled with alixizumab demonstrated efficacy in the treatment of statin intolerant coronary heart disease, with clinical symptoms being mitigated, blood lipid profiles enhanced, and vascular endothelial function improved. The medication displays favourable safety profiles.