Abstract： Objective： To observe the clinical effect of floating acupuncture combined with standing digital occupational therapy（OT）for post-stroke hand spasticity in a real-world setting. Methods：Eighty-six patients with post-stroke hand spasticity treated at Guangdong Second Traditional Chinese Medicine Hospital between June and December 2023 were divided into the combination group and the control group by various treatment approaches，with 43 cases in each group. Both groups received conventional therapy. The control group received additional standing digital OT，while the combination group additionally received floating acupuncture plus standing digital OT. After four weeks of treatment and propensity score matching（PSM）to control confounders，36 patients per group completed the study. The clinical effect， scores of Modified Ashworth Scale（MAS）， shortened Fugl-Meyer Assessment for Upper Extremity （sFMA-UE），and Modified Barthel Index（MBI）were compared between the two groups. Results：After four-week treatment，the total effective rate was 97.22%（35/36）in the combination group，higher than 83.33%（30/36）in the control group（P＜0.05）. Both groups showed significant increase in MAS，sFMA-UE，and MBI scores（P＜0.05）. The combination group had higher scores in MAS，sFMA-UE，and MBI（P＜0.05）. Conclusions：Floating acupuncture combined with standing digital OT enhances therapeutic efficacy，reduces hand spasticity，improves upper limb motor function，and increases activities of daily living in post-stroke hand spasticity patients.