Abstract： Objective:To observe the therapeutic effects of vasodilators on neurogenic decompression sickness，and to identify the optimal timing of drug administration through clinical comparison，thereby providing guidance for clinical treatment.Methods:The prospective randomized single-blind method was employed to categorize 166 patients with acute neurogenic decompression sickness，based on the time from onset to treatment，into three groups：Group A（≤ 6 hours）with 45 cases，Group B（6-24 hours）with 79 cases，and Group C（>24-72 hours）with 42 cases. Each group was further divided into treatment and control subgroups based on whether vasodilation therapy was added besides hyperbaric oxygen therapy. Neurological functional changes were evaluated using the European stroke scale（ESS）and the Barthel index（BI）.Results:After treatment，the treatment subgroups in all three groups showed higher ESS scores compared with the control subgroups，with statistically significant inter-group differences in the later stages（ P<0.05）. The inter-group difference increased as the treatment duration prolonged. The disability rates in the treatment subgroups were significantly lower than those in the control subgroups，and the recovery rates were also significantly higher. Furthermore，the earlier the treatment adopted，the lower the disability rate and the higher the recovery rate achieved. Conclusion:The combined treatment of hyperbaric oxygen therapy with vasodilators for acute neurogenic decompression sickness demonstrates significantly superior efficacy compared with using hyperbaric oxygen therapy alone，with earlier treatment yielding better outcomes.