Objective To explore the impact of moxibustion combined with Shenque acupoint patching on postoperative gastrointestinal function in patients undergoing major orthopedic surgery. Methods Convenience sampling method was used to select patients undergoing major orthopedic surgery from Luoyang Orthopedic-Traumatological Hospital of Henan Province (Henan Provincial Orthopedic Hospital) between October and December 2024 as the research subjects. The trial group received intervention with moxibustion combined with Shenque acupoint patching on the basis of routine care, while the control group only received routine care. The time of first flatus/defecation, frequency of defecation within 7 days, incidence/degree of abdominal distension at 72 hours, and adverse events were compared between the two groups after surgery. Results Finally, 94 subjects were included, including 51 in the trial group and 43 in the control group. There was no statistically significant difference in the general condition between the two groups of patients (P>0.05). Compared with the control group, patients in the trial group had a shorter first flatus time [6.00 (5.00, 9.00) vs. 14.00 (6.83, 19.13) h] and spontaneous defecation time [26.00 (21.00, 52.10) vs. 50.20 (26.42, 69.35) h], and an increase in spontaneous defecation frequency [6.00 (4.00, 7.00) vs. 4.00 (3.00, 5.00)] within 7 days after surgery, with statistically significant differences (P<0.05). Neither the trial group nor the control group experienced any adverse events. Conclusion Moxibustion combined with Shenque acupoint patching can safely and effectively promote the recovery of gastrointestinal function in patients undergoing major orthopedic surgery, and is worthy of clinical promotion.