Objective To investigate the effect of "essence-filling and intelligence-enhancing" acupuncture on cognitive function and serum homocysteine (Hcy) in patients with mild post-stroke cognitive impairment (PSCI). Methods A total of 116 patients with mild PSCI were randomly divided into control group(58 patients，55 were actually included in the study) and acupuncture group (58 patients，54 were actually included in the study).The patients in the control group were given basic intervention,rehabilitation training,and oral administration of donepezil 5 mg once every night,seven times a week for 8 consecutive weeks,and those in the acupuncture group were given "essence-filling and intelligence-enhancing" acupuncture for 30 minutes each time,once a day and six times a week for 8 weeks,in addition to the treatment in the control group.The two groups were observed and compared in terms of Montreal Cognitive Assessment (MoCA) score,Mini-Mental State Examination (MMSE) score,Barthel Index (BI),and serum Hcy level before and after treatment,and treatment outcome was evaluated based on MMSE score.Results After treatment,both groups had significant increases in MoCA score,MMSE score,and BI (P<0.05) and a significant reduction in serum Hcy level (P<0.05),and compared with the control group,the acupuncture group had significantly greater changes in these indices (P<0.05).The acupuncture group had a significantly better clinical outcome than the control group (P<0.05).Conclusion For patients with mild PSCI,"essence-filling and intelligence-enhancing" acupuncture can significantly improve cognitive function and activities of daily living,alleviate the damage of Hcy to brain function,and protect the function of the brain.