Objective To investigate the contents of the diester aconitum alkaloids in Poge Jiuxin Decoction with Radix Aconite Lateralis from different regions. Methods High performance liquid chromatography ( HPLC) was used to determine the mass fraction of the diester aconitum alkaloids in Poge Jiuxin Decoction. Its conditions were as follows: Technologies Athena C18-WP ( 4.6 mm×250 mm, 5 μm) column with methanol ( 0.1% triethylamine) and H2O ( 70 :30) as a mobile phase, the flow rate was 1.0 mL/min, the column temperature was 35 ℃ and the detection wavelength was 235 nm. The relationship between toxicity and regions was explored with diester aconitum alkaloids as an indicator. Results The mass fraction of three kinds of diester aconitum alkaloids in the decoction were obviously different between the thirteen different regions of Radix Aconite Lateralis. The mass fraction of total diester aconitum alkaloids in Radix Aconite Lateralis from Jiangyou, Sichuan province, was taken as a standard. The samples from Hanzhong, Shanxi province, and Changzhou, Jiangsu province were similar to the standard, those from Tengchong, Yunnan Province, Dalian, Liaoning province, and Liangshan, Sichuan Province were much higher, and the one from Tengchong, Yunnan province was approximately 3 times the standard, while these from Shijiazhuang, Hebei province, Nanyang, Henan province and Baise, Guangxi Province were much lower than the standard. Conclusion The results could provide scientific reference on relationship among the regions, dosage, clinic drug use and safety evaluation for further application of Poge Jiuxin Decoction.