Abstract：Objective：To observe the effect of wrist-ankle acupuncture based on the theory of twelve cutaneous regions in preventing deep vein thrombosis （DVT） in lower extremities of elderly patients with acute exacerbation of chronic obstructive pulmonary disease （COPD） in intensive care unit （ICU）. Methods：A total of 78 elderly patients with acute exacerbation of COPD treated in the ICU of Tongde Hospital of Zhejiang Province from May 2022 to April 2024 were selected. They were divided into the control group and the observation group by the random number table method，with 39 patients in each group. On the basis of active treatment for the primary disease，the control group was intervened with intermittent compression， while the observation group was intervened with wrist-ankle acupuncture based on the theory of twelve cutaneous regions in addition to the control group's treatment. Both groups received continuous intervention for seven days. The symptom scores of lower extremities， coagulation function indicators [prothrombin time（ PT），activated partial thromboplastin time（ APTT），fibrinogen（ FIB）]，peak blood flow velocities in the popliteal and femoral veins， and incidence of DVT in the lower extremities were compared between the two groups. Results：After intervention，the scores of lower extremity swelling，pain，increased skin temperature，and skin color were decreased in both groups when compared with those before intervention， and the scores of these four symptoms were lower in the observation group than in the control group，differences being significant （P＜0.05）. In the observation group， PT and APTT were prolonged when compared with those before intervention and were longer than those in the control group，while FIB level was decreased when compared with that before intervention and was lower than that in the control group， differences being significant （P＜0.05）. There were no statistically significant differences in PT，APTT，and FIB levels before and after intervention in the control group （P＞0.05）. The peak blood flow velocities in the popliteal and femoral veins were increased in both groups when compared with those before intervention，and the peak blood flow velocities in these veins were higher in the observation group than in the control group，differences being significant（ P＜0.05）. The incidence of DVT in the lower extremities was 5.13%（ 2/39） in the observation group， which was lower than 23.08% （9/39） in the control group， the difference being significant （P＜ 0.05）. Conclusion：Wrist-ankle acupuncture based on the theory of twelve cutaneous regions can relieve symptoms of lower extremities， improve coagulation function， increase venous blood flow velocity of lower extremities， and effectively reduce the incidence of DVT in the lower extremities of elderly patients with acute exacerbation of COPD treated in the ICU.