Objective To explore the effect of meridian sinew row needling combined with dermal needling on spasticity of post-stroke patients with upper limb hemiparalysis. Methods Four hundred and eighty-eight cases of post-stroke patients with upper limb spasticity were randomly divided into two groups at the ratio of 1: 1, the group of meridian sinew row needling combined with dermal needling (group A, 244 cases) and western medication group (group B, 244 cases). Coupled with rehabilitation, the patients in the group A were given meridian sinew row needling combined with dermal needling where five shu points were specifically selected, and three yang meridians of the hand were treated with acupuncture with muscle region, and three yin meridians of the hand were treated with dermal needles; the patients in the group B was treated with conventional western medication with piracetam injection and cerebroprotein hydrolysate included. Clinical efficacy was evaluated among patients in the two groups after three weeks of continuous treatment, and upper limb spasticity and motor functions were observed through modified Asworth Scale and Fugl-Meyer Assessment Scale (FMA) before and after treatment. Results For Asworth Scale, group A was significantly superior to group B (3.04土1.29 VS 3.88土1.54, P<0.05); for FMA scale, group A was also significantly superior to group B (48.67士15.64 VS 42.96士14.72, P<0.05); mitigations of motor status of upper limb joints in group A, such as remission of shoulder adduction (90. 5%), pronation of forearm (70.7%), elbow joint flexion (73.1%), wrist joint flexion (80.9%) and finger flexion (88.1%), were superior to those of group B (70.0%, 60.0%, 61.9%, 57.4%, 63.2%, all P<0.05). . Conclusion Good clinical efficacy of the treatment with combined with dermal needling on spasticity of post-stroke patients with upper limb hemiparalysis is achieved.