Abstract：Objective：To systematically evaluate the clinical efficacy，electroencephalogram（EEG）abnormality improvement， and safety of acupuncture combined with medication in the treatment of post-stroke epilepsy（PSE）， thus providing references for clinical treatment and decision-making. Methods： Major databases were searched to obtain randomized controlled trial data on acupuncture and medication therapy for PSE，including Wanfang Data，VIP Database， China National Knowledge Infrastructure （CNKI）， China Biology Medicine disc （CBM）， Cochrane Library， PubMed， and Embase， with the search period ranging from the inception of each database to October 8， 2024. According to the established inclusion and exclusion criteria， the literature was carefully screened， and key information was extracted. The methodological quality and risk level of the selected literature were comprehensively evaluated using the "Cochrane" risk of bias assessment system. Meta -analysis of the total effective rate and EEG abnormality improvement rate of acupuncture combined with Chinese medicine in treating PSE was performed using Stata 14 statistical analysis software，and the frequency，duration of seizures，and adverse events mentioned in the involved literature were recorded in detail. Results：A total of 11 studies involving 901 patients with PSE were included，with the total effective rate as the primary outcome measure and the EEG abnormality improvement rate as the secondary outcome measure. The Meta-analysis results showed that：The total effective rate of acupuncture combined with Chinese medicine in treating PSE was higher than that of Chinese medicine or western medicine alone [RR=1.276， 95% CI （1.276，1.196），P＜0.01]. In terms of EEG abnormality improvement rate，the acupuncture combined with Chinese medicine group was superior to other groups [RR=1.791， 95% CI （1.361， 2.356）， P＜0.01]. Conclusion： Acupuncture combined with Chinese medicine has a significant comprehensive clinical effect in treating PSE， with better outcomes in improving the total effective rate and increasing the rate of EEG normalization compared to Chinese medicine alone，and the therapeutic effect is stable.