Abstract： Objective： To observe the effect of the therapy of five- needle- at- neck acupuncture combined with Xingnao Qiyan tang on cerebral hemodynamics， swallowing function and surface electromyography activities in elderly patients with ischemic stroke(IS) and dysphagia. Methods：A total of 125 elderly patients with IS and dysphagia were divided into the rehabilitation group and the acupuncture group according to different treatment methods. A total of 62 patients in the rehabilitation group were treated with Xingnao Qiyan tang and routine rehabilitation treatment， and 63 patients in the acupuncture group were additionally treated with five- needle- at- neck acupuncture based on the treatment of the rehabilitation group. The swallowing function， cerebral hemodynamics and duration of electromyography activities of the muscles related to swallowing function were compared between the two groups. Results： After treatment，the scores of Swallowing Ability Scale(SAS) and water swallowing test(WST) and vascular resistance index(RI) in the two groups were decreased when compared with those before treatment(P＜ 0.05)， and the scores of videofluorographic swallowing study(VFSS)， mean blood flow velocity(Vm) and maximum peak flow velocity(Vs) were increased(P＜0.05)； after treatment， the scores of SSA and WST and RI in the acupuncture group were lower than those in the rehabilitation group(P＜0.05)，and the scores of VFSS， Vm and Vs in the acupuncture group were higher(P＜0.05). After treatment， the duration of electromyography activities of infrahyoid muscles and submental muscles in the two groups was shortened when compared with that before treatment(P＜0.05)； after treatment， the duration of above activities in the acupuncture group was shorter than that in the rehabilitation group(P＜0.05). Conclusion：By improving the flexibility of swallowing reflex， the therapy of five- needle- at- neck acupuncture combined with Xingnao Qiyan tang for elderly patients with IS and Dysphagia can improve the swallowing function， regulate the cerebral hemodynamics，adjust the duration of electromyography activities of muscles related to swallowing function，and enhance the clinical effect.