The invention discloses a rheumatism cold compress paste which comprises a backing layer, a gel drug layer and an anti-bonding layer, wherein the gel drug layer contains the following raw materials: sodium polyacrylate, carbomer, glycerol, dihydroxyaluminum aminoacetate, tartaric acid, purified water, medical borneol, camphor, diclofenac sodium, menthol, atropa belladonna liquid extract, ginger oil, propylene glycol, glycerol, medical azone, diphenhydramine, oleum menthae and capsaicin. The invention also discloses a preparation method for the rheumatism cold compress paste. The method comprises the following steps: firstly, preparing a gel drug, and then coating the backing layer with the gel drug by machine so as to form the gel drug layer, coating the gel drug layer with the anti-bonding layer, cutting, puncturing and slicing, thereby acquiring the bruise cold compress paste. No organic solvent is added into the rheumatism cold compress paste disclosed by the invention; the rheumatism cold compress paste can be directly used for coating and does not need to be heated; the technology is simple and no chemical residue exists; the rheumatism cold compress paste is free from irritability and stimulation, is high in drug loading capacity and moisture retention, has high compatibility with skin, is anti-ageing, has excellent weather fastness and lasting viscidity and can be repeatedly uncovered and pasted; the production cost is lower.