Abstract：Objective：To conduct a comparative analysis on the effects of thunder-fire moxibustion and ordinary moxa stick moxibustion on neurological function， cognitive function， daily living activity ability， and serum homocysteine （Hcy） levels in patients with post-stroke cognitive impairment （PSCI）. Methods：A total of 104 PSCI patients admitted to Rehabilitation Hospital Affiliated to Fujian University of Traditional Chinese Medicine from May to November 2023 were randomly divided into two groups by computer：the thunder-fire moxibustion group and the moxa stick moxibustion group，with 52 patients in each group. Both groups received routine treatment，rehabilitation，and care. Based on this， Baihui （DU 20） point and Shenting （DU 24） point were selected. The moxa stick moxibustion group was treated with ordinary moxa stick moxibustion， while the thunder-fire moxibustion group was treated with thunder-fire moxibustion. Both groups were treated for four weeks. Compared the National Institutes of Health Stroke Scale （NIHSS）， Montreal Cognitive Assessment （MoCA） and Modified Barthel Index （MBI） scores and serum Hcy levels between the two groups before and after treatment. Results： After treatment， NIHSS scores and serum Hcy levels in the two groups were decreased when compared with those before treatment， and the NIHSS score in the thunder-fire moxibustion group was lower than that in the moxa stick moxibustion group， differences being significant （P＜0.05）. The scores and total scores of all dimensions of MoCA in both groups were increased when compared with those before treatment，and the visual space and executive ability，attention，and delayed recall scores and total scores in the thunder-fire moxibustion group were higher than those in the moxa stick moxibustion group， differences being significant（ P＜0.05）. Both groups showed an increase in MBI scores when compared with those before treatment，with the thunder-fire moxibustion group having a higher MBI score than the moxa stick moxibustion group， differences being significant （P＜0.05）. After treatment， there was no significant difference in naming， language， abstraction， orientation scores， and serum Hcy levels between the two groups （P＞0.05）. Conclusion： Both of the above two moxibustion methods can improve neurological function，cognitive function，and daily living activity ability of PSCI patients， but the therapeutic effect of thunder-fire moxibustion is better than that of ordinary moxa stick moxibustion. Both moxibustion methods can reduce serum Hcy levels with equivalent therapeutic effects．