Abstract： Objective： To observe the clinical effect of acupuncture at back-shu point combined with auricular point seed-pressing for prediabetes mellitus (PDM) with spleen deficiency and damp exuberance syndrome. Methods： A total of 60 cases of PDM patients with spleen deficiency and damp exuberance syndrome were selected and divided into the intervention group and the control group according to the random number table method，with 30 cases in each group. Both groups were given health education and life style intervention； the control group was treated with auricular point seed- pressing， and the intervention group was additionally treated with acupuncture at back-shu point based on the treatment of the control group. Both groups were treated for 2 months. The clinical effects，traditional Chinese medicine syndrome scores， blood glucose indexes， and islet function indexes were compared between the two groups. Results： After treatment， the total clinical effective rate was 86.67% in the intervention group， higher than that of 63.33% in the control group (P＜0.05). The scores of body obesity， abdominal enlargement， fatigue and hypodynamia， poor appetite and loose stool， and tastelessness or greasy mouth in the two groups were decreased when compared with those before treatment (P＜0.05)，and the scores of body obesity， abdominal enlargement， fatigue and hypodynamia， poor appetite and loose stool， and tastelessness or greasy mouth in the intervention group were lower than those in the control group (P＜0.05). The levels of hemoglobin A1c (HbA1c)， fasting blood glucose (FBG)， and postprandial 2- hour blood glucose (P2hBG) in the two groups were decreased when compared with those before treatment (P＜0.05)，and the levels of HbA1c，FBG，and P2hBG in the intervention group were lower than those in the control group (P＜0.05). The levels of fasting insulin (FINS) and fasting C-peptide (FCP)，insulin sensitivity index (ISI)， and Homeostatic Model Assessment of Insulin Resistance (HOMA- IR) in the two groups were decreased when compared with those before treatment (P＜0.05)，and the levels of FINS and FCP，ISI，and HOMA- IR in the intervention group were lower than those in the control group (P＜0.05). Conclusion： Acupuncture at back- shu point combined with auricular point seed- pressing has a good curative effect in treating PDM with spleen deficiency and damp exuberance syndrome，which can alleviate the clinical symptoms of patients，and improve their blood glucose levels and islet function.