OBJECTIVE: To evaluate the efficacy of scalp-acupuncture on subjects with hemiplegic paralysis of acute ischaemic stroke(AIS).METHODS: One hundred and twenty patients with hemiplegic paralysis of 1 to 7 d post stroke, aged40 to 75 years, were randomly allocated to receive either standard care(control group) or standard care plus 30 min of scalp-acupuncture applied to the bilateral anterior oblique line of the vertex-temporal(MS6) for 14 d(6 d/week)(trial group). The outcome measures included the National Institutes of Health Stroke scale(NIHSS) for neurological deficits, the Fugl-Meyer assessment(FMA) for limb impairment, and Barthel index(BI) for activities of daily living before and after intervention. The manual muscle test(MMT) was assessed at pre-intervention, at the first post-intervention immediately, and at the 14 th day after intervention commencement.Measurements were recorded by a blinded investigator at different time points after initiating the intervention.RESULTS: The trial group had a greater increase in MMT(P < 0.05), FMA, and BI scores(P < 0.01), and a greater decrease in NIHSS scores(P < 0.01) from pre-intervention to post-intervention, and the control group had a greater increase in MMT scores(P < 0.05), and a greater decrease in NIHSS scores(P < 0.01) from pre-intervention to post-intervention. The improvement in MMT(P < 0.01), FMA, BI(P < 0.05), and NIHSS(P < 0.01) scores in the trial group was superior to that of the control group.Meanwhile, scalp-acupuncture intervention had an immediate effect on myodynamia of patients with hemiplegic paralysis after acute ischaemic stroke in this randomized controlled trial.CONCLUSION: The early scalp-acupuncture intervention after stroke effectively increased myodynamia of the affected limbs, improved neurological deficit degrees, and daily living ability.