Abstract：Objective：To observe the clinical effect of the combination use of three-meridian needling in rows at occiput and Xuantong Decoction on vestibular migraine. Methods： A total of 80 patients with vestibular migraine were selected and divided into the western group and the combination group according to the random number table method，with 40 cases in each group. The western medicine group was treated with routine western medicine， and the combination group was treated with Xuantong Decoction and three-meridian needling in rows at occiput based on the treatment of the western medicine group. The levels of calcitonin gene related peptide (CGRP) ， nitric oxide (NO) ， endothelin-1 (ET-1) ， 5-hydroxytryptamine (5-HT)，matrix metalloproteinase-9 (MMP-9) and substance P (SP)，abnormal rates of optokinetic test，spontaneous nystagmus test，cold and heat test and saccade test，traditional Chinese medicine syndrome scores，and scores of Dizziness Handicap Inventory (DHI)，Berg Balance Scale (BBS)， Headache Impact Test (HIT-6) and Europe Health-Related Quality of Life Questionnaire 5-Dimensions Scale (EQ-5D) before and after treatment， and the clinical effects were compared between the two groups. Results： After treatment， the contents of CGRP and SP in the two groups were reduced when compared with those before treatment(P＜0.05)， and the above two contents in the combination group were lower than those in the western medicine group (P＜0.05)；the 5-HT contents in the two groups were increased when compared with those before treatment (P＜0.05)，and the 5-HT content in the combination group was higher than that in the western medicine group (P＜0.05). After treatment，the contents of NO， ET-1 and MMP-9 in the two groups were decreased when compared with those before treatment (P＜ 0.05)，and above three contents in the combination group were lower than those in the western medicine group (P＜0.05). After treatment，the abnormal rates of optokinetic test and spontaneous nystagmus test in the combination group were decreased when compared with those before treatment (P＜0.05)， and the above two rates were lower than those in the western medicine group (P＜0.05)； the abnormal rates of caloric test and saccade test in the two groups were decreased (P＜0.05)，there being no significance in the difference (P＞0.05). After treatment，the traditional Chinese medicine syndrome scores in the two groups were decreased when compared with those before treatment (P＜0.05)， and the above scores in the combination group were lower than those in the western medicine group (P＜0.05). After treatment， the frequency of vertigo attack in the two groups were decreased when compared with those before treatment (P＜0.05)，and the frequency of vertigo attack in the combination group was lower than that in the western medicine group (P＜0.05)； the duration of vertigo each time in the two groups were shortened when compared with those before treatment (P＜0.05)，and the duration of vertigo each time in the combination group was shorter than that in the western medicine group (P＜0.05). After treatment，the scores of DHI， HIT-6 and EQ-5 D in the two groups were reduced when compared with those before treatment (P＜0.05)， and the above three scores in the combination group were lower than those in the western medicine group (P＜0.05)；the BBS scores in the two groups were increased when compared with those before treatment (P＜0.05)，and the BBS score in the combination group was higher than that in the western medicine group (P＜0.05). The total effective rate in the combination group was 97.50%，higher than that of 80.00% in the western medicine group (P＜0.05). Conclusion：The combination use of three-meridian needling in rows at occiput and Xuantong Decoction can improve the levels of CGRP，SP，5-HT，NO，ET-1 and MMP-9 of patient with vestibular migraine， relieve the symptoms of vertigo and headache， mitigate the nystagmus and balance disorder，and enhance the quality of life and clinical effect.