Abstract： Objective： To observe the clinical effect of the combination use of Tongguan Liqiao acupuncture combined with repetitive transcranial magnetic stimulation （rTMS） on dysphagia after stroke （DAS）. Methods：A total of 92 DAS patients admitted to the Department of Rehabilitation Medicine of Hangzhou Xiaoshan District Hospital of Chinese Medicine from January 2021 to December 2024 were enrolled in the study. They were divided into the observation group and the control group by the random number table method，with 46 cases in each group. Both groups were given conventional treatment，the control group was additionally treated with rTMS，and the observation group was additionally treated with Tongguan Liqiao acupuncture based on the treatment in the control group. Both groups were treated for four weeks. The clinical efficacy，neurological function [National Institutes of Health Stroke Scale （NIHSS）]， swallowing function [Water Swallow Test （WST） and Video Fluoroscopic Swallowing Study （VFSS）]，oral intake ability [Functional Oral Intake Scale （FOIS）]，surface electromyography indexes of infrahyoid muscles and cerebral circulation dynamic parameters [middle cerebral artery pulsatility index（ PI），mean blood flow velocity（ Vm），diastolic blood flow velocity （Vd），systolic blood flow velocity （Vs）] were compared between the two groups. Results：After four weeks of treatment，the total effective rate was 91.11%（ 41/45） in the observation group，higher than that of 75.00%（ 33/44） in the control group （P＜0.05）. Both NIHSS and WST scores in the two groups decreased compared with those before treatment （P＜0.05），with the observation group showing lower scores than the control group （P＜0.05）. Both VFSS and FOIS scores in the two groups increased compared with those before treatment （P＜0.05）， with the observation group exhibiting higher scores than the control group （P＜0.05）.The amplitude of electromyographic activity （resting/ working） of infrahyoid muscles in both groups increased compared with those before treatment （P＜0.05）， and the amplitude of electromyographic activity （resting/working） of infrahyoid muscles in the observation group was higher than that in the control group （P＜0.05）. The swallowing time of the infrahyoid muscles in both groups was shortened compared with that before treatment （P＜0.05），and the swallowing time of the infrahyoid muscles in the observation group was shorter than that in the control group （P＜0.05）. The PI of the middle cerebral artery in both groups decreased compared with that before treatment （P＜0.05），and the PI of the middle cerebral artery in the observation group was lower than that in the control group （P＜0.05）. The Vm， Vd， and Vs of the middle cerebral artery in both groups increased compared with those before treatment （P＜0.05），and the Vm，Vd，and Vs of the middle cerebral artery in the observation group were higher than those in the control group （P＜0.05）. Conclusion： The combination use of Tongguan Liqiao acupuncture and rTMS has a significant curative effect on DAS， which can reduce the neurological deficits，improve swallowing function，enhance oral intake ability and amplitude level of electromyographic activity in the infrahyoid muscles，shorten swallowing duration，and promote the cerebral microcirculation.