Yuan Jiangzhou Quwo (now part of Shanxi) person. Grandfather Xu Ji served as the military governor of Jiangzhou during the Jin Dynasty, and father Xu Riyan was the judicial commissioner of Rongzhou, both proficient in medicine. Mother Han Shi once served as a dietary physician to Zhuangsheng Empress Dowager Suoluhoutieni, the mother of Yuan Shizu Kublai Khan.

Xu Guozhen was well-versed in the classics and history, especially skilled in medical arts. Before Shizu ascended the throne, he was summoned to Hanhai (now Altai Mountains) to oversee medical affairs. Xu was loyal and outspoken in his advice, earning deep trust from Shizu, and once cured Shizu's foot ailment. Upon Shizu's accession, he was appointed as Ronglu Grand Master, in charge of the Taiyiyuan affairs, and awarded a golden tally. Later, he was given a golden tiger tally, promoted to Minister of Rites, appointed as a Grand Scholar of the Jixian Academy, and advanced to Guanglu Grand Master. In September of the 25th year of Zhiyuan (1288), he presided over the compilation of Zhiyuan Zengxian Materia Medica , the only officially compiled materia medica of the Yuan Dynasty, unfortunately, the book is lost. Later, he compiled the Imperial Pharmacy Formulary in 11 volumes, which collected many medical formulas from the Southern Song, Jin, and Yuan dynasties, some of which are not found in other medical texts, providing valuable references for clinical applications. This book also spread to countries such as Korea and Japan.