Abstract：Objective：To observe the clinical effect of the therapy of nape needling at six points with electroacupuncture combined with three-step tuina manipulation for vertebral artery cervical spondylosis and its effect on the carotid artery blood flow of patients. Methods： A total of 76 patients with vertebral artery cervical spondylosis were selected as the study subjects， and were divided into the control group and the observation group according to the sequence of admission， 38 cases in each group. The control group was given conventional acupuncture and tuina for treatment， and the observation group was treated with nape needling at six points with electroacupuncture combined with three- step tuina manipulation. Both groups were treated for two courses， one week being one course， with two- day rest between each course. The clinical effect，the symptom scores and the hemodynamics of vertebral artery in the two groups were compared before and after treatment. Results：After treatment，the scores of vertigo and neck-shoulder pain in the two groups were decreased when compared with those before treatment(P＜0.05)，and the decrease of the above two scores in the observation group was more significant than that in the control group(P＜0.05). After treatment， the Peak Systolic Velocity(PSV)， vascular Pulsatility Index(PI)，Time-Mean Flow Velocity(TMFV) and vascular Resistance Index(RI) were improved in both groups，and the improvement of the above four hemodynamics of vertebral artery in the observation group was more significant than that in the control group，differences being significant(P＜0.05). The cure rate was 50.00% in the observation group，higher than that of 23.68% in the control group，the difference being significant(P＜0.05). Conclusion：The therapy of nape needling at six points with electroacupuncture combined with three-step tuina manipulation has significant therapeutic effect in treating patients with vertebral artery cervical spondylosis，which can improve the local blood flow velocity with a good prognosis.