Objective: To investigate the efficacy and safety of Azelastine-Fluticasone Nasal Spray in the treatment of patients with Allergic Rhinitis (AR). Methods: A total of 80 AR patients were selected and assigned to either the observation group (n=40) or the control group (n=40) according to different treatment methods. Patients in the control group received Mometasone Furoate treatment, while those in the observation group received Azelastine-Fluticasone Nasal Spray treatment. After 4 weeks of continuous treatment, nasal physiological function, immune function, sleep quality, quality of life, and the incidence of adverse reactions were compared between the two groups. Results: After 4 weeks of treatment, compared with the control group, the total clinical effective rate in the observation group was higher (P < 0.05). Nasal resistance in the observation group was lower (P<0.05), while the nasal ventilation area and ciliary movement rate were higher (P<0.05). Compared with the control group, the observation group exhibited higher percentages of CD4+ T cells and a higher CD4+/CD8+T cell ratio (P<0.05), along with lower percentages of CD8+T cells and reduced serum levels of immunoglobulin E (IgE), interleukin-4 (IL-4), and interleukin-1β (IL-1β). The Pittsburgh Sleep Quality Index (PSQI) and Rhinoconjunctivitis Quality of Life Questionnaire (RQLQ) scores in the observation group were lower than those in the control group (P<0.05). During the treatment period, there was no statistically significant difference in the incidence of adverse reactions between the two groups (P>0.05). Conclusion: Compared with Mometasone Furoate monotherapy, Azelastine-Fluticasone Nasal Spray can improve the total clinical effective rate in AR patients, and shows superior benefits in improving nasal physiological function, regulating immune function, enhancing sleep and quality of life, without increasing the risk of adverse reactions.