The invention discloses a preparation method of a coated tablet containing acetaminophen and tramadol hydrochloride. The preparation method includes the following steps: S1, mixing the active ingredient, filler and disintegrant to obtain a premixed powder; the active ingredient is acetaminophen and tramadol hydrochloride, and the mass ratio of the two is 325:37.5; S2. During the stirring process, add a binder to the premixed powder, and granulate to obtain wet granules; the binder is hypromellose EF or hypromellose E5; S3, the wet granules are dried and sized , and then adding a lubricant for mixing to obtain the blended granules; S4, compressing the blended granules to obtain tablets; S5, coating the tablets to obtain the final product. The granulation process of the present invention is easy to operate, solves the problem of poor compressibility of paracetamol, tablet fragments, etc., and at the same time makes paracetamol and tramadol hydrochloride have a higher similarity, stable preparation process, and convenient for large-scale production , has good bioavailability and quality safety.