Objective To evaluate the therapeutic effect of scalp acupuncture and body acupuncture in combination with rehabilitation exercise for hemiplegia and shoulder pain after stroke. Methods Sixty cases were randomly divided into an acupuncture rehabilitation group (33 cases) and a routine treatment group (27 cases). Both two groups received rehabilitation exercise, acupuncture rehabilitation group was treated with scalp acupuncture and body acupuncture, and in body acupuncture, Pishu(脾俞 BL 20), Weishu (胃俞 BE 21), Zusanli (足三里 ST 36), Fenglong (丰隆 ST 40), Xuehai (血海 SP 10), and accompanying points according to the symptoms were selected; in scalp acupuncture, Baihui (百会 GV 20), Sishencong (四神聪EX-HN 1), motor area, vascular dilation and constriction area were selected. Routine treatment group was treated with western drugs, including dehydration with mannitol to reduce intracranial pressure, control blood pressure, and brain cell protective agent was given, triamcinolone acetate solution for shoulder pain or cortisone acetate solution for blocking treatment. The treatment was given once a day, four weeks were one course, and four courses were given in all. The hemorheological indices and the clinical effect of two groups were compared. Results The effective rate of acupuncture rehabilitation group was 90.9% (30/33), better than that of 70.4% (19/27) in routine treatment group (P〈0.05); whole blood viscosity low shear and middle shear, plasma viscosity and hematocrit after the treatment became lowered than those before the treatment in acupuncture rehabilitation group (all P〈0.05); whole blood viscosity and plasma viscosity after the treatment was also lowered than those before the treatment in routine treatment group (both P〈0.05); whole blood viscosity low shear and middle shear, plasma viscosity and hematocrit after the treatment in acupuncture rehabilitation group were obviously lowered than those of routine treatment grou