Abstract： Objective： To observe the clinical efficacy of unblocking collaterals and calming mind acupuncture combined with auricular point seed-pressing in treating post-stroke insomnia with internal blockage of blood stasis syndrome. Methods： A total of 60 cases of post-stroke insomnia patients with internal blockage of blood stasis syndrome admitted to Hangzhou Rehabilitation Hospital from January 2024 to January 2025 were selected and divided into the trial group and the control group using the random number table method， with 30 cases in each group. The control group received auricular point seed-pressing treatment，while the trial group received unblocking collaterals and calming mind acupuncture combined with auricular point seed-pressing treatment. The treatment course for both groups covered four weeks. The clinical efficacy，as well as sleep quality，quality of life，and neurotransmitter levels before and after treatment were compared between the two groups. Results：After treatment，the total effective rate in the trial group was 90.00% （27/30），which was higher than 66.67% （20/30） in the control group（ P＜0.05）. The Pittsburgh Sleep Quality Index （PSQI） and Self-Rating Scale of Sleep （SRSS） scores decreased in both groups compared with those before treatment （P＜0.05）， and the scores of these two scales in the trial group were lower than those in the control group （P＜0.05）. The scores on the short version of the Stroke-Specific Quality of Life Scale （SV-SS-QoL） increased in both groups compared with those before treatment （P＜0.05），and the SV-SS-QoL scores in the trial group were higher than those in the control group （P＜0.05）. The levels of 5-hydroxytryptamine （5-HT） and melatonin （MT） increased in both groups compared with those before treatment （P＜0.05），and the levels of these two indicators in the trial group were higher than those in the control group （P＜0.05）. The dopamine （DA） levels decreased in both groups compared with those before treatment （P＜0.05），and the DA level in the trial group was lower than that in the control group （P＜0.05）. Conclusion： Unblocking collaterals and calming mind acupuncture combined with auricular point seed-pressing for post-stroke insomnia with internal blockage of blood stasis syndrome can improve clinical efficacy， enhance sleep quality，and improve patients′ quality of life.