Objective To observe clinical manifestations and TCM pattern features of cough with a cold sensation in the back (back cold) ,and to discuss and analyze its etiology and pathogenesis,in the hope of providing evidence for the treatment of cough. Methods Cases with cough as a chief complaint accompanied by a cold sensation in the back were selected. We analyzed the general information, underlying respiratory diseases,clinical characteristics of and relevant factors for cough with a cold sensation in the back,and summarized the onset characteristics,etiology,pathogenesis,and TCM patterns. Results Cough with a cold sensation in the back was common in clinical practice. Moreover,a cold sensation in the back was closely related to cough. Common pathological elements included dampness-heat,yang deficiency,retention of phlegm and morbid fluid,and pathogenic wind,etc. The pattern identification of TCM showed that spleen-stomach dampness-heat pattern accounted for 22. 8% of all cases; dampness-heat pattern complicated with lung yang deficiency,21. 3%; lung yang deficiency, 17. 3%; and yang deficiency of the lung and spleen,12. 7% respectively,etc. Conclusion A cold sensation in the back often accompanies cough,closely related to seasons,climate changes and etc. This symptom of varying degrees could be present in people of different ages and with different respiratory diseases. Most commonly-seen TCM patterns are retention of dampness-heat in the spleen and stomach and yang deficiency of the lung. Pathogenic dampness and heat may hinder qi movement. Moreover,the lung-spleen yang is deficient,and defensive yang fails to distribute. Consequently,the lung fails to spread and depurate. This is probably its main disease mechanism.