Abstract：Objective：To observe the efficacy and safety of mind-regulating acupuncture combined with Tuina in treating senile insomnia complicated by mild cognitive impairment （MCI）. Methods： A total of 110 senile insomnia patients with MCI who were treated in the outpatient department of Ningbo Integrated Traditional Chinese and Western Medicine Hospital from January 2023 to June 2025 were selected and divided into the treatment group and the control group according to the random number table method，with 55 cases in each group. Among them，13 patients （7 in the treatment group and 6 in the control group） dropped out due to inability to adhere to treatment and follow-up. The treatment group received mind-regulating acupuncture combined with Tuina， and the control group received sham acupuncture combined with Tuina. Treatments were administered three times per week for 6 consecutive weeks. The cure rate and marked improvement rate was compared between the two groups；the changes in the scores of Pittsburgh Sleep Quality Index （PSQI），Montreal Cognitive Assessment （MoCA），Wechsler Memory Scale （WMS-RC），Self-Rating Anxiety Scale（ SAS），Self-Rating Depression Scale（ SDS），and Fatigue Severity Scale（ FSS） and the polysomnography parameters [sleep efficiency（ SE），sleep onset latency（ SOL），total sleep time（ TST），wake after sleep onset（ WASO）] were observed before treatment， and after 6 weeks of treatment and follow-up. Results： The cure rate and marked improvement rate was 72.9% （35/48） in the treatment group， higher than that of 51.0% （25/49） in the control group （P＜0.05）. After 6 weeks of treatment and follow-up，the PSQI scores in the two groups were decreased when compared with those before treatment （P＜0.05），and the PSQI score in the treatment group was lower than that in the control group at the same stage （P＜0.05）. After 6 weeks of treatment and follow-up，the scores of MoCA and WMSRC in both groups were increased when compared with those before treatment （P＜0.05）， and the two scores in the treatment group were higher than those in the control group at the same stage （P＜0.05）. After 6 weeks of treatment and follow-up，the scores of SAS and SDS in both groups were reduced when compared with those before treatment （P＜ 0.05）. After 6 weeks of treatment，the scores of SAS and SDS in the treatment group were lower than those in the control group （P＜0.05）. After 6 weeks of follow-up，the SDS score in the treatment group was lower than that in the control group（ P＜0.05），there being no significance being found in the comparison of SAS score between the two groups（ P＞ 0.05）. After 6 weeks of treatment and follow-up， the FSS scores in both groups dwindled when compared with those before treatment （P＜0.05）. After 6 weeks of treatment，the FSS score in the treatment group was lower than that in the control group （P＜0.05）. After 6 weeks of follow-up，there was no significance being found in the comparison of FSS score between the two groups （P＞0.05）. After 6 weeks of treatment and follow-up，SE in the two groups was increased when compared with that before treatment （P＜0.05）， SOL and WASO were shortened when compared with those before treatment （P＜0.05），and TST was lengthened when compared with that before treatment （P＜0.05）；SE in the treatment group was higher than that in the control group at the same stage （P＜0.05），SOL and WASO were shorter than those in the control group at the same stage （P＜0.05），and TST was longer than that in the control group at the same stage （P＜0.05）. During treatment，there were 2 cases of subcutaneous hematoma and 2 cases of local pain after acupuncture in the treatment group；there was 1 case of post-acupuncture pain in the control group，which disappeared naturally after several days. Conclusion：The combination use of mind-regulating acupuncture and Tuina can improve the sleep quality and cognitive function of senile insomnia patients with MCI， mitigate their anxiety and depression， and relieve fatigue.