Objective To evaluate the effectiveness of local warming combined with intravenous preinjection lidocaine for the prevention and treatment of rocuronium injection pain. Methods This study was a single center，randomized，double-blind study. A total of 388 patients，aged 18 ~ 65 years，ASA class Ⅰ~Ⅲ，who underwent general anesthesia surgery from March to June 2022 in West China Hospital were included. The patients were randomly divided into four groups: control group，local warming group，lidocaine group， and local warming combined with lidocaine group，with 97 patients in each group. The temperature settings of the control group and the local warming group were 32℃ and 43℃ respectively，and 2 ml of 0.9% normal saline was preinjected；the temperature settings of lidocaine group and local warming combined with lidocaine group were 32℃ and 43℃ respectively，and 2 ml lidocaine was preinjected. Grade of withdrawal response，heart rate，blood pressure and dislodgement of indwelling needle in painful limbs during rocuronium injection as a bolus injection were recorded. Results the incidence of rocuronium injection pain was 60.8%，53.6%，30.9% and 27.8% in the control group，local warming group，lidocaine group and local warming combined with lidocaine group，respectively. Compared with the control group or the local warming group，the incidence of injection pain，the incidence of moderate and severe injection pain and the severity of injection pain in the local warming combined with lidocaine group were significantly reduced（P < 0.05），but there was no significant difference compared with the lidocaine group（P > 0.05）. No adverse events such as dropping or dislocation of the retaining needle occurred. The younger the age and the smaller the diameter of the retaining needle，the higher the risk of rocuronium injection pain，and the patients with raw propofol injection pain were also more likely to have rocuronium injection pain. Conclusion Local warming combined with intravenous preinjection of lidocaine could reduce the incidence of rocuronium injection pain. However， compared with intravenous preinjection of lidocaine，local warming combined with intravenous preinjection of lidocaine did not reduce the incidence of rocuronium injection pain.