〔Abstract〕 Objective To study the clinical efficacy of small needle knife in the treatment of cervicoshoulder myofascial pain syndrome. Methods 80 patients with cervicoshoulder myofascial pain syndrome treated in Huazhou Hospital of Traditional Chinese Medicine from January 2020 to January 2021 were randomly divided into control group and observation group according to the method of digital random table, with 40 cases in each group. The control group was treated with routine acupuncture and moxibustion, and the observation group was treated with small needle knife. The clinical therapeutic effects of the two groups were observed. The levels of serum serotonin (5-HT) and β-endorphin (β-ET), pain visual analogue scale (VAS) score, Barthel index (BI) and cervical neck disability index (NDI) were observed in the two groups before and after treatment. Results the effective rate of the observation group was 97.5%, which was significantly higher than 82.5% of the control group, and the difference was statistically significant (P < 0.05). Before treatment, there was no significant difference in the levels of serum 5-HT and β-ET between the two groups, but after treatment, the level of β-ET in the observation group was significantly higher than that in the control group, while the level of 5-HT in the observation group was significantly lower than that in the control group, and the differencse were statistically significant (P < 0.05). Before treatment, there was no significant difference in the scores of VAS, BI and NDI between the two groups, but after treatment, the score of BI in the observation group was significantly higher than that in the control group, while the scores of VAS and NDI in the observation group were significantly lower than those in the control group, and the differences were statistically significant (P < 0.05). Conclusion The treatment of cervicoshoulder myofascial pain syndrome with small needle knife is beneficial to the recovery of neck and shoulder function, and obvious relief of pain.