Abstract: With the development and prevalence of Esoteric Buddhism in the Tang Dynasty, a large number of Buddhist medical sutras related to Esoteric Buddhism were translated, and the phenomenon of Esoteric Buddhism in Buddhist medicine began to emerge. Through sorting, it can be seen that Esoteric Buddhism was widely involved in the practice of royal and folk medicine in the Tang Dynasty, and there are also many Tang Dynasty murals which demonstrate the use of esoteric spells to treat diseases in Dunhuang Grottoes. It can be said that using esoteric spells to solve various medical problems was an important manifestation of the phenomenon of Esoteric Buddhism in Buddhist medicine during the Tang Dynasty. Studying this phenomenon has important value and significance for understanding the development of Buddhist medicine and Esoteric Buddhism in the Tang Dynasty.