Abstract： Objective： To observe the clinical effect of thunder- fire moxibustion for mild cognitive impairment (MCI) in middle- aged and elderly people based on theory of conducting qi back to its origin. Methods： A total of 66 cases of middle- aged and elderly patients with MCI were selected and given retrospective study method， and divided into the observation group and the control group based on whether they were treated with thunder-fire moxibustion based on conducting qi back to its origin，with 34 and 32 cases in each group respectively. The control group was intervened with routine treatment and nursing， and the observation group was additionally treated with thunder- fire moxibustion based on conducting qi back to its origin based on the treatment of the control group. Both groups were intervened for 7 days. Before and after intervention， the scores of Mini- Mental State Examination (MMSE)， Montreal Cognitive Assessment (MoCA)， QOL questionnaire for Dementia (QOL- D)， and traditional Chinese medicine(TCM) syndrome were compared between the two groups. The adverse reactions in the two groups were recorded. Results：After intervention，the scores of MMSE，MoCA，and QOL-D in the two groups were increased when compared with those before intervention，and the scores of MMSE，MoCA， and QOL- D in the observation group were higher than those in the control group， differences being significant (P＜0.05). The TCM syndrome scores in the two groups were decreased when compared with those before intervention，and the TCM syndrome score in the observation group was lower than that in the control group，differences being significant (P＜0.05). During treatment，there was no adverse reaction between the two groups. Conclusion：Under the guidance of the theory of conducting qi back to its origin， the application of thunder- fire moxibustion for middle- aged and elderly patients with MCI can effectively alleviate their clinical symptoms，improve their quality of life and cognitive function，with high safety.