Abstract：Objective：To observe the clinical effect of abdominal three-needle acupuncture combined with Buzhong Yiqi Decoction for urinary incontinence after stroke with spleen-kidney qi deficiency syndrome. Methods： A total of 62 cases of patients with urinary incontinence after stroke with spleenkidney qi deficiency syndrome were selected and divided into the control group and the observation group according to the random number table method，with 31 cases in each group. One case was excluded from each of the two groups，and 30 cases were included in each group ultimately. The control group was given conventional drug treatment and rehabilitation training. The observation group was treated with abdominal three-needle acupuncture combined with Buzhong Yiqi Decoction on the basis of the treatment of the control group. Both groups were treated for three months. Compared the clinical efficacy， International Consultation on Incontinence Questionnaire-Urinary Incontinence Short Form (ICIQ-SF) scores， daily urinary indicators (daily urination frequency， daily leakage frequency， and daily average single urine volume)，residual urine volume，and Incontinence Quality of Life Scale (I-QOL) scores in the two groups， and recorded the occurrence of adverse reactions. Results： After three months of treatment， the total effective rate was 93.33% in the observation group，which was higher than that of 70.00% in the control group， the difference being significant (P＜0.05). After three months of treatment， the ICIQ-SF scores， daily urination frequency， daily leakage frequency， and residual urine volume were decreased when compared with those before treatment， and the daily average single urine volume and I-QOL scores were increased when compared with those before treatment，differences being significant (P＜0.05)；the ICIQ-SF score in the observation group was lower than that in the control group， the daily urination frequency， daily leakage frequency， and residual urine volume in the observation group were fewer than those in the control group，the daily average single urine volume in the observation group was more than that in the control group，and the I-QOL score in the observation group was higher than that in the control group，differences being significant (P＜0.05). During the treatment period，neither group experienced any significant adverse reactions. Conclusion： Abdominal three-needle acupuncture combined with Buzhong Yiqi Decoction has a good therapeutic effect on urinary incontinence after stroke with spleen-kidney qi deficiency syndrome. It can effectively improve the symptoms of urinary incontinence and bladder function， thereby improving the quality of life of patients，with high safety.