Objective To investigate the clinical effect of tendon- regulation and bone- setting manipulation combined with facilitated stretching in the treatment of old ankle joint sprain. Methods A total of 60 patients with old ankle joint sprain were randomly divided into treatment group and control group using a randomized controlled design, with 30 patients in each group. The patients in the treatment group were given tendon- regulation and bone- setting manipulation combined with facilitated stretching, and those in the control group were given electromagnetic radiation and acupuncture. The Baird- Jackson ankle joint function score, Visual Analogue Scale (VAS) score, and tenderness score were compared after two courses of treatment. Results Both groups had significant improvements in the VAS score, Baird- Jackson ankle joint function score, and tenderness score after treatment, and the treatment group had significantly better improvements than the control group (P<0.05). Conclusion In patients with old ankle joint sprain, tendon- regulation and bone- setting manipulation combined with facilitated stretching can improve their symptoms and clinical outcome.