Objective To observe the clinical efficacy of acupuncture and bloodletting therapy at triple points in the treatment of posterior circulation ischemic vertigo. Methods Forty patients with posterior circulation ischemic vertigo were randomly and equally divided into treatment group and control group. The treatment group received acupuncture and bloodletting therapy at triple points, while the control group received conventional acupuncture on the cervical spine. The treatment lasted for three consecutive weeks. The improvement in vertigo, Dizziness Handicap Inventory (DHI) score, and changes in hemodynamic parameters of the vertebral-basilar artery were evaluated. Results The treatment group had slightly better treatment outcomes than the control group. However, there was no significant difference in the outcome distribution between the two groups (P>0.05). Both groups had significantly reduced DHI scores after treatment (all P<0.05); compared with the control group, the treatment group had significantly greater reductions in scores for all items (all P<0.05). Both groups had significant changes in hemodynamic parameters of the vertebral-basilar artery after treatment (all P<0.05); there were significant differences in the changes in all indices after treatment between the two groups (all P<0.05). Conclusion Acupuncture and bloodletting therapy at triple points can substantially improve clinical outcomes in patients with posterior circulation ischemic vertigo, and it can reduce the influence of vertigo disorder on daily life and improve hemodynamics of the vertebral-basilar artery.