Abstract： Objective： To observe the clinical efficacy of Tongguan Liqiao acupuncture combined with motor imagery therapy in the treatment of pediatric cerebral palsy. Methods： A total of 90 children with cerebral palsy admitted to Foshan Shunde Maternal and Child Health Hospital from August 2023 to August 2025 were selected and randomly divided into the control group and the observation group using the random number table method，with 45 cases in each group. The control group was treated with motor imagery therapy，while the observation group received Tongguan Liqiao acupuncture combined with motor imagery therapy. The clinical efficacy of the two groups was compared，and the changes in traditional Chinese medicine syndrome scores， limb movement abilities [Modified Ashworth Scale （MAS） scores]， cerebral hemodynamic parameters [mean blood flow velocity in the anterior cerebral artery （ACA）， middle cerebral artery （MCA）， and posterior cerebral artery （PCA）]， and dysarthria severity [Frenchay Dysarthria Assessment （FDA） scores] before and after treatment were compared. Results：After treatment，the total effective rate in the observation group was 95.56%（ 43/45），which was significantly superior to that of 80.00%（ 36/45） in the control group （P＜0.05）. After treatment， the scores for main symptoms， secondary symptoms， and the total scores of traditional Chinese medicine syndrome in both groups decreased compared with those before treatment （P＜0.05），and all three scores in the observation group were lower than those in the control group （P＜0.05）. After treatment，the MAS scores for upper and lower limbs in both groups decreased compared with those before treatment （P＜0.05），and the scores in the observation group were lower than those in the control group （P＜0.05）. After treatment，the blood flow velocities in the ACA， MCA， and PCA increased in both groups compared with those before treatment （P＜0.05）， and the levels of these three indicators in the observation group were higher than those in the control group （P＜0.05）. After treatment， the FDA scores for articulatory organ movement， speech， respiration， and reflexes in both groups improved compared with those before treatment （P＜0.05）， and all sub-item scores in the observation group were higher than those in the control group （P＜0.05）. Conclusion： Tongguan Liqiao acupuncture combined with motor imagery therapy demonstrates favorable efficacy in the treatment of pediatric cerebral palsy. It can effectively improve traditional Chinese medicine syndromes， accelerate rehabilitation， enhance limb motor function and cerebral arterial blood flow velocity，and alleviate dysarthria.