Objective To evaluate the clinical effect of acupoint injection therapy for paralysis of oculomotor nerve with Chinese herbal medicines. Methods A total number of 456 patients from 3 centers with paralysis of oculomotor nerve were randomly divided into an acupoint injection group and a control group with 228 cases each. Patients in the acupoint injection group were treated with injection of Chinese herbal medicines to Jingming (睛明BL 1), Yangbai (阳白GB 14), Sibai(四白ST 2), Tongziliao (瞳子嫪GB 1) on the affected side, and Ganshu (肝俞BL 18) on both sides, Compound Angelica Injection was the main drug, and the corresponding acupoints and other injection drugs were also used according to differentiation of syndrome. Patients in the control group were treated with common western medicine. The treatment was given once a day, 10 times constituted one course with 3 days of interval. After 3 courses, the effect was assessed. TCM syndrome score, eyeball movement degree, the sizes of oculi rimae and pupil of the two groups were recorded before and after treatment. Results The effective rate of acupoint injection group was 91.7% (209/228), and that of the control group was 73.6% (168/228).There was statistical significance in comparing the difference between the two groups (P<0.05). TCM syndrome scores of the two groups after the treatment became less obviously than those before the treatment (P<0.01, P<0.05), the score of acupoint injection group was more reduced than that of the control group (P<0.05). Eyeball movement degree and oculi rimae were enlarged and the pupil reduced in the affected eye in both groups after the treatment (all P<0.05). The musculus rectus medialis for the eyeball movement in the acupoint injection group was more improved than that of the control group, and the oculi rimae was bigger in the acupoint injection group than that in the control group (both P<0.05). Conclusion Acupoint injection therapy with Chinese herbal medicines has assured effect on the treatment of oculomotor paralysis.