Abstract: Objective To investigate the therapeutic effect of Tongdu Yinao Huatan decoction combined with scalp and neck acupuncture in the treatment of dysphagia after stroke. Methods A total of 90 patients with dysphagia after stroke treated in Jinhua People’s Hospital from January 2023 to July 2024 were randomly assigned to an observation group and a control group, with 45 patients in each group, using a random number table method. The control group was treated with conventional therapy, while the observation group was treated with Tongdu Yinao Huatan decoction combined with scalp and neck acupuncture. Both groups were treated for four consecutive weeks. Clinical efficacy, standardized swallowing assessment（SSA） scores, functional oral intake scale（FOIS） scores, swallowing quality of life questionnaire（SWAL-QOL） scores, as well as levels of prealbumin（PA）, albumin（ALB）, hemoglobin（Hb）, and the mean blood flow velocity of the anterior cerebral artery（ACA）, middle cerebral artery（MCA）, and posterior cerebral artery（PCA） were compared between two groups after four weeks of treatment. Results After four weeks of treatment, the total effective rate in the observation group was higher than that in the control group（P ＜ 0.05）. The SSA scores decreased, while the FOIS and SWAL-QOL scores increased in both groups compared to baseline（P ＜ 0.05）. The SSA scores of the observation group were lower than those of the control group, while the FOIS scores and SWAL-QOL scores were higher（P ＜ 0.05）. The levels of PA, ALB and Hb in both groups were higher than those before treatment （P＜0.05）,and the levels of PA,ALB,and Hb in the observation group were higher than those in the control group （P＜0.05）.The mean blood flow velocities of MCA,ACA and PCA in both groups were faster than those before treatment （P＜0.05）,and the mean blood flow velocities of ACA,MCA and PCA in the observation group were faster than those in the control group （P＜0.05）. Conclusion For patients with dysphagia after stroke,the combination of Tongdu Yinao Huatan decoction and scalp and neck acupuncture is obviously effective and has good clinical application value.