Objective To compare the efficacy and safety of mirtazapine and fluoxetine in the treatment of somatoform disorders.Methods 82 patients were randomly divideded into mirtazapine group and fluoxetine group,all the patients were treated for 6 weeks.The efficacy was evaluated with Hamilton depression rating scale and symptom checklist,the side effects were evaluated with treatment emergent symptom scale.Results The total effective rate of the mirtazapine group was 88％.The total effective rate of the fluoxetine group was 80％.There was no difference between the two groups in efficacy (x2 =0.13,P ＞ 0.05).After the first week of treatment,by Symptom checklist,somatization,anxiety and total score of mirtazapine group were significantly lower than the fluoxetine group (t =2.97,3.01,3.73,all P ＜ 0.05).After the sixth week of treatment,somatization,interpersonal,depression,anxiety,fear and total score of mirtazapine group were significantly lower than the fluoxetine group (t =2.01,2.36,3.25,3.62,2.17,3.84,all P ＜ 0.05).Mirtazapine group had no significant adverse drug reactions.Fluoxetine group had four cases of adverse drug reactions.Conclusion Mirtazapine in the treatment of patients with somatoform disorders has more rapid onset and drug side effects is less than fluoxetine.