Abstract：Objective：To observe the clinical efficacy of cervical six-needle acupuncture combined with Tongmai Huayu Decoction for vertebral artery type cervical spondylosis（VACS）of qi stagnation and blood stasis type. Methods： A total of 98 VACS patients of qi stagnation and blood stasis type treated at Traditional Chinese Medical Hospital of Zhuji from March 2023 to December 2024 were divided into the control group and the observation group using the random number table method，with 49 cases in each group. Both groups received conventional cervical exercise training， with the control group additionally receiving Tongmai Huayu Decoction and the observation group receiving both the decoction and cervical six-needle acupuncture for four weeks. The clinical efficacy， traditional Chinese medicine syndromes， Cervical Dysfunction Index（NDI）， Copenhagen Neck Functional Disability Scale（CNFDS） scores， mean peak blood flow velocity（Vm）and resistance index（RI）of vertebral artery and basilar artery， peak action potential and nerve conduction velocity of cervical nerve root，and cerebral blood flow were compared between the two groups. Results： After treatment，the total effective rate in the observation group was 95.74%（45/47），which was higher than 83.33%（40/48）in the control group（P＜0.05）. The scores of neck stiffness and pain， vertigo， limb numbness and total scores of traditional Chinese medicine syndromes in the two groups were decreased compared with those before treatment（P＜0.05），while the scores of neck stiffness and pain，vertigo，limb numbness and total scores of traditional Chinese medicine syndromes in the observation group were lower than those in the control group（P＜ 0.05）. The scores of NDI and CNFDS in the two groups were decreased compared with those before treatment（P＜ 0.05）， and the scores of NDI and CNFDS in the observation group were lower than those in the control group（P＜ 0.05）. The values of Vm of vertebral artery and basilar artery in the two groups were increased compared with those before treatment（P＜0.05），and the values of Vm of vertebral artery and basilar artery in the observation group were higher than those in the control group（P＜0.05）. The RI of vertebral artery and basilar artery in the two groups was decreased compared with that before treatment（P＜0.05）， and the RI of vertebral artery and basilar artery in the observation group was decreased than that in the control group（P＜0.05）. The peak value of action potential and nerve conduction velocity of cervical nerve root in the two groups was increased compared with that before treatment（P＜0.05）. The peak value of action potential and nerve conduction velocity of cervical nerve root in the observation group was higher than that in the control group（P＜0.05）. The cerebral blood flow of the two groups was increased compared with that before treatment（P＜0.05）. The change rate of cerebral blood flow in the observation group was higher than that in the control group（P＜0.05）. Conclusion：Cervical six-needle combined with Tongmai Huayu Decoction has good curative effect in the treatment of VACS of qi stagnation and blood stasis type，which is helpful to improve vertebral basilar artery hemodynamics and cerebral blood flow，and improve cervical function.