Abstract： Objective： To observe the clinical effect of wind-extinguishing and du-regulating filiform needle acupuncture combined with rehabilitation training on essential hypertension (EH) complicated with acute ischemic stroke (AIS). Methods：A total of 92 patients with EH complicated with AIS were selected and divided into the control group and the treatment group by dual color sphere method，with 46 cases in each group. Both groups received basic treatment with western medicine； the control group was additionally treated with rehabilitation training，and the treatment group was additionally treated with windextinguishing and du-regulating filiform needle acupuncture based on the treatment of the control group. Both groups were treated for 4 weeks. The clinical effects，traditional Chinese medicine (TCM) syndrome scores， modified Rankin Scale (mRs) scores， National Institutes of Health Stroke Scale (NIHSS) scores， and modified Barthel Index (MBI) scores were compared between the two groups. Results： After treatment，the total clinical effective rate was 95.65% in the treatment group，and 89.13% in the control group，there being no significance in the difference (P＞0.05). After the rank-sum test，the clinical effect in the treatment group was better than that in the control group， the difference being significant (P＜0.05). After treatment， the scores of decreased sensation， hemiplegia， crooked mouth and tongue， awkward speech，nausea and vomiting，dizziness，and excessive phlegm in the two groups were decreased when compared with those before treatment， and the scores of the seven TCM syndromes in the treatment group were lower than those in the control group，differences being significant (P＜0.05). After treatment， the scores of mRs and NIHSS in the two groups were decreased when compared with those before treatment，and the MBI scores were increased when compared with those before treatment，differences being significant (P＜0.05)；the scores of mRs and NIHSS in the treatment group were lower than those in the control group， and the MBI score was higher than that in the control group， differences being significant (P＜0.05). Conclusion： Wind-extinguishing and du-regulating filiform needle acupuncture combined with rehabilitation training has a good clinical effect in treating EH complicated with AIS，which can effectively improve the clinical symptoms and prognosis of patients.