Objective: To analyze the medical security effect of catastrophic illness in Guangxi. Methods: The descriptive statistics method was used to analyze the effects of medical security for catastrophic illness in Guangxi from different areas and different diseases. Results: After comprehensive compensation of basic medical insurance, serious diseases insurance and medical assistance, the reimbursement rates of total medical expenses for outpatient service for special chronic diseases and special treatment of serious diseases in Guangxi were 79.23 %and 79.10 %, respectively. The reimbursement rates of the triple system for outpatient service for special chronic diseases and special treatment of serious diseases in each region ranged from 69 %to 87 %and 75 %to 83 %, respectively. The diseases with less number and frequency of treatment but higher proportion of self-paid are congenital cleft lip and palate, neuroblastoma and other diseases. Conclusion: It is suggested to strengthen the comprehensive security of the triple system and improve the security level of catastrophic illness. All regions should speed up the pooling level, improve the level of information service, and improve the dynamic adjustment of drug catalogue to pay attention to the protection of catastrophic illness.