Abstract： Objective： To observe the effects of scalp acupuncture and body acupuncture combined with occupational therapy on cognition， muscular spasticity， and fine motor of affected limbs in patients with spastic hemiplegia of upper limbs after stroke. Methods： A total of 100 patients with stroke were treated in the Ningbo Rehabilitation Hospital from March 2023 to March 2024 were selected and divided into the control group and the study group according to the random number table method， with 50 cases in each group. The control group received occupational therapy for rehabilitation，and the study group received scalp acupuncture and body acupuncture combined with occupational therapy for rehabilitation. After two months of treatment， the differences in neurological function [National Institutes of Health Stroke Scale （NIHSS），Neurological Deficit Scale （NDS）]，cognitive function [Montreal Cognitive Assessment （MoCA）]， muscular spasticity [Modified Ashworth Scale （MAS） for upper limbs]， fine motor function of the upper limbs [Simplified Fugl-Meyer Assessment （FMA）， Carroll Upper Extremity Function Test （UEFT）]， and activities of daily living [Modified Barthel Index （MBI） ， Functional Independence Measure （FIM）] were compared between the two groups before and after treatment. Results： After treatment， the scores of NIHSS and NDS in the two groups were decreased when compared with those before treatment （P＜0.05），and the study group had lower scores of NIHSS and NDS compared to the control group （P＜0.05）. MoCA scores in thte two groups increased significantly after treatment （P＜0.05）， with the study group showing higher MoCA score than the control group （P＜0.05）. MAS scores for muscular spasticity in the two groups decreased significantly after treatment （P＜0.05），with the study group showing lower MAS score than the control group （P＜0.05）. The scores of FMA and UEFT in the two groups increased significantly after treatment （P＜0.05）， with the study group showing higher scores of FMA and UEFT than the control group （P＜0.05）. The scores of MBI and FIM in the two groups increased significantly after treatment （P＜0.05），with the study group showing higher scores of MBI and FIM than the control group （P＜0.05）. Conclusion：Scalp acupuncture and body acupuncture combined with occupational therapy has a significant therapeutic effect on patients with spastic hemiplegia of upper limbs after stroke，which can improve neurological function， cognitive function， and muscular spasticity of upper limbs， as well as enhance fine motor function of upper limbs and activities of daily living.