Objective: To investigate the effect of nerve mobilization combined with head and body needling on patients with hemiplegia after stroke. Methods: A total of 126 patients with post-stroke hemiplegia admitted to multiple centers from January 2019 to August 2021 were randomly divided into the combined group (n=42), the head and body acupuncture group (n=42), and the nerve loosening group (n=42) according to different treatment plans. The patients in the head and body acupuncture group underwent giant acupuncture with head and body acupuncture, and the nerve loosening group underwent manipulative nerve loosening. Patients in the combined group underwent manipulative nerve loosening on the basis of head and body acupuncture. Before treatment, 4 weeks and 8 weeks after treatment, neurological function was assessed by the National Institute of Health stroke scale (NIHSS) and Berg Balance Scale (BBS) was used to assess the balance function of the limbs. The amplitude and threshold of the median nerve of the affected side were measured by electromyographic evoked potentiometer, and the motor function of the limbs was assessed by Fugl-Meyer Motor Function Assessment Scale (FMAS). Daily activity ability was assessed by the Modified barthel index (MBI) score and the Time Up and Go Test (TUGT) score. Results: Compared with the same group before treatment, the NIHSS scores, edema grading scores, shoulder pain and hand pain VAS scores of the patients in the three groups at 4 and 8 weeks after treatment decreased, while the BBS scores, upper limb movement scores, lower limb movement scores and MBI scores increased (all P＜0.05); The median nerve F wave threshold decreased, F wave amplitude increased, and TUGT time shortened (P＜0.05). After 4 and 8 weeks of treatment, the NIHSS score of the combined group was lower than that of the head and body acupuncture group and nerve loosening group (P＜0.05), and the BBS score and limb motor function score were higher than that of the head and body acupuncture group and nerve loosening group (P＜0.05). The F wave threshold of the affected median nerve in the combined group was lower than that of the head needle and nerve loosening groups, and the F wave amplitude was higher than that of the head needle and nerve loosening group (P＜0.05). The edema grading score, shoulder pain VAS score in the combined group were lower than those in the head and body acupuncture group and nerve loosening group (P＜0.05). The TUGT time of the combined group was shorter than that of the head body acupuncture group and the nerve loosening group, and the MBI score was higher than that of the head body acupuncture group and the nerve loosening group (P＜0.05). Conclusion: The combined application of head and body acupuncture and nerve mobilization in post-stroke hemiplegia can effectively alleviate the nerve injury, promote the recovery of limb motor function, and improve the balance function and daily activity ability.