Soil salinization and alkalinization frequently co-occur in naturally saline and alkaline soils. To understand the characteristics of mixed salt-alkali stress and adaptive response of Medicago ruthenica seedlings to salt-alkali stress, water content of shoots, growth and photosynthetic characteristics of seedlings under 30 salt-alkaline combinations (salinity 24-120 mM and pH 7.03-10.32) with mixed salts (NaCl, Na2SO4, NaHCO3, and Na2CO3) were examined. The indices were significantly affected by both salinity and pH. The interactive effects between salt and alkali stresses were significant, except for photosynthetic pigments. Water content of shoots, relative growth rates of shoots and roots and pigment concentrations showed decreasing trends with increasing salinity and alkalinity. The root activity under high alkalinity and salinity treatments gradually decreased, but was stimulated by the combined effects of low alkalinity and salinity. The survival rate decreased with increased salinity, except at pH 7.03-7.26 when all plants survived. Net photosynthetic rate, stomatal conductance and intercellular CO2 concentration decreased with increased salinity and pH. M. ruthenica tolerated the stress of high salt concentration when alkali concentration was low, and the synergistic effects of high alkali and high salt concentrations lead to the death of some or all seedlings. M. ruthenica appeared to be salt-alkali tolerant. Reducing the salt concentration or pH based on the salt components in the soil may be helpful to abate damage from mixed salt-alkaline stress. and J. Y. Yang ... [et al.].