Objective: To explore the therapeutic efficacy of combining rupatadine tablets with mometasone furoate nasal spray in the treatment of allergic rhinitis (AR) and its effect on serum inflammation-related indicators. Methods: A total of 118 AR patients were enrolled. The patients were divided into two groups according to different treatment regimens: a control group (n = 59) or an observation group (n = 59). The control group received mometasone furoate nasal spray alone, while the observation group received both mometasone furoate nasal spray and rupatadine tablets. Treatment duration was 4 weeks for both groups. Before and after treatment, nasal symptom scores (TNSS), total nasal accompanying symptom scale (TNNSS), and the rhinoconjunctivitis quality of life questionnaire (RQLQ) were assessed. Serum levels of immunoglobulin E (IgE), interleukin (IL)-4, IL-6, and IL-10, as well as peripheral blood eosinophil (EOS) counts, were measured. Results: The total effectiveness rate was higher in the observation group (96.61%) compared to the control group (83.05%) (P < 0.05). After treatment, TNSS, TNNSS, and RQLQ scores were lower in the observation group than in the control group (P < 0.05). Serum IgE, EOS counts, and IL-4 and IL-6 levels were also lower in the observation group (P < 0.05), while IL-10 levels were higher (P < 0.05). Conclusion: The combination of rupatadine tablets and mometasone furoate nasal spray alleviates nasal symptoms, reduces IgE and EOS levels, mitigates inflammatory responses, and enhances therapeutic outcomes in AR patients.