In allusion to the problem of low efficiency of medicine carton packaging machine and poor box opening effect of the narrow and long carton, a new box suction and opening mechanism of carton packaging machine with box suction mechanical arm, carton opening auxiliary setting device was put forward. The working principle of the mechanism was analyzed; the kinematics model was built, and compiled the mechanism calculation software to obtain a set of mechanism parameters that can achieve the work requirements. The virtual prototype was built, the kinematics simulation test was carried out to obtain the motion trajectory, and the simulation analysis was basically consistent with the theoretical calculation result, the box suction and opening test of the physical prototype was carried out, and the results verified the correctness of the design results.