Abstract：Objective：To observe the curative effect of small needle knife guided by meridian sinew theory for cervical spondylotic radiculopathy(CSR) and its effect on contents of serum substance P(SP). Methods：The clinical data of 80 cases of CSR patients were reviewed. A total of 40 cases of patients treated with needle knife were assigned to the treatment group， and the other 40 cases treated with acupuncture therapy were assigned to the control group. Visual Analogue Scale(VAS) scores，Neck Disability Index(NDI) and SP levels before and after treatment as well as the clinical effect after treatment in the two groups were compared. Results：After treatment，VAS scores，SP levels，each score of NDI and the total scores in the two groups were decreased when compared with those before treatment(P＜0.05)；VAS score，SP level，each score of NDI and the total score in the treatment group were all decreased when compared with those in the control group(P＜0.05). The total effective rate was 77.50% in the control group and 95.00% in the treatment group，the difference being significant(P＜ 0.05). Conclusion：Under the guidance of meridian sinew theory，the application of small needle knife for CSR can obviously down-regulate SP levels，significantly relieve neck and shoulder pain and related dysfunction，promote the early recovery of patients，and improve their self-care ability.