Abstract： Objective： To observe the clinical efficacy of spot-prick fire needling at the oropharyngeal region combined with conventional western medicine therapy for sarcopenic dysphagia with liver-spleen deficiency syndrome. Methods： A total of 60 patients with sarcopenic dysphagia with liver-spleen deficiency syndrome admitted to the Department of Geriatrics and Rehabilitation Medicine Inpatient Unit at Wenzhou TCM Hospital of Zhejiang Chinese Medical University from October 2022 to October 2024 were selected and divided into the control group and the trial group using the simple random method， with 30 patients each. The control group received conventional western medicine therapy combined with rehabilitation exercise，and the trial group received additional spot-prick fire needling at the oropharyngeal region based on the treatment of the control group. Both groups were given treatment for two courses， with each course lasting two weeks. The clinical efficacy after treatment， the changes in ultrasound parameters of geniohyoid muscle movement（movement amplitude，movement velocity and movement duration），swallowing function [Water Swallowing Test（WST）and Standardized Swallowing Assessment（SSA）scores] before and after treatment，and the incidence of adverse events during treatment were respectively compared between the two groups. Results： After treatment，the trial group showed a higher total effective rate（93.33%，28/30）than the control group（73.33%，22/ 30）（P＜0.05）. Geniohyoid muscle movement amplitude and velocity in the two groups increased compared with those before treatment（P＜0.05）， and the geniohyoid muscle movement amplitude and velocity were greater and faster， respectively， than those in the control group（P＜0.05）. Geniohyoid muscle movement duration in the two groups decreased compared with that before treatment（P＜0.05），and the geniohyoid muscle movement duration in the trial group was shorter than that in the control group（P＜0.05）. SSA scores in the two groups decreased compared with those before treatment（P＜0.05），and SSA score in the trial group was lower than that in the control group（P＜0.05）. WST grades in the two groups improved compared with those before treatment（P＜0.05），and WST grade in the trial group was better than that in the control group（P＜0.05）. During treatment，the incidence of adverse events in the trial group （10.00%， 3/30）was significantly lower than that in the control group（33.33%， 10/30）（P＜0.05）. Conclusion： Spot-prick fire needling at the oropharyngeal region combined with conventional western medicine therapy improves the clinical efficacy， enhances the geniohyoid muscle motor function and swallowing function， and demonstrates good safety in patients with sarcopenic dysphagia with liver-spleen deficiency syndrome.