Abstract：Objective：To observe the clinical effect of the therapy of acupuncture combined with virtual reality cognitive training system (VRCTS) on senile patients with post-stroke mild cognitive impairment (PSMCI). Methods：A total of 126 senile patients with PSMCI were divided into the routine group and the study group according to the random number table method，with 63 cases in each group. The routine group was treated with VRCTS，and the study group was additionally given acupuncture based on the treatment of the routine group. The scores of Montreal Cognitive Assessment (MoCA)， Mini-Mental State Examination (MMSE) and Activities of Daily Living (ADL) before and after treatment，and the clinical effects were compared between the two groups. Results：The total effective rate was 85.71% in the study group， higher than that of 69.84% in the routine group (P＜0.05). After treatment，the scores of MoCA and MMSE in the two groups were increased (P＜0.05)，and the above two scores in the study group were higher than those in the routine group (P＜0.05). After treatment， the ADL scores in the two groups were decreased (P＜0.05)， and the ADL score in the study group was lower than that in the routine group (P＜0.05). Conclusion： The curative effect of therapy of acupuncture combined with VRCTS on senile patients with PSMCI is better than that of single VRCTS，which can effectively improve the cognitive function of patients and enhance the activities of daily living.