Objective To study effects of Ca, Mg, Cu, Zn, VD combined with protein on ovarian functions in female rats with coal?burning fluorosis. Methods A total of 120 clean?grade SD female rats with body weights of about 80 g were used. Rats were randomly divided into control, fluorosis, element, and element + protein groups with 30 rats in each group. Model groups were fed edible raw coal mixed with peat and different formulas of zhijin roasted corn feed. Rats were sacrificed at 60, 120, and 180 days, and bilateral ovaries were harvested. Expression of apoptosis proteins Bcl?2 and Bax in ovarian granulosa cells was observed by immunohistochemistry. HE staining was used to observe ovarian tissue morphology and changes in follicle and corpus luteum numbers. Results There was no statistical significance in the protein expression of Bcl?2 in ovarian granulosa cells. The expression of Bax in each group was compared with that in the fluorosis group, and a significant difference was found at 120 and 180 days ( P <0.05). There were significant differences at 180 days between the two intervention groups ( P <0.05). Compared within each group, Bax expression in the fluorosis group gradually increased and the difference was significant ( P <0.05). There was a significant difference at 60 and 180 days for various elements ( P < 0.05). Over a prolonged time in the fluoride group, ovarian granulosa cells showed progressive edema, atretic follicles, and corpus luteum degradation, and mature follicles were decreased significantly. Ovarian granular cells in the two intervention groups showed rare mild edema and normal numbers of follicles at all levels. Atresia of follicles and degeneration of the corpus luteum were decreased significantly. Compared with the fluorosis group, there were significant differences in atresia follicles between control and multiple element + protein groups at 60 days, and the control group and two intervention groups at 120 and 180 days ( P <0.05). Conclusions Ca, Mg, Cu, Zn, and VD antagonize the reproductive toxicity of coal?burning fluorosis and reduce protein expression of Bax and the number of atresia follicles. And the effects of intervention combined with protein can be better.