〔Abstract〕 Objective To explore the clinical efficacy of exercise training combined with acupuncture at meridian selection points on patients with primary insomnia (PI). Methods A total of 106 patients with PI admitted to the Third People's Hospital Affiliated to Fujian University of Traditional Chinese Medicine from January 2019 to January 2022 were selected and divided into an observation group and a control group by random number table method, with 53 cases in each group. The control group were treated with acupuncture at meridian selection points, while patients in the observation group were combined with exercise training on the basis of the control group. The relevant parameters of patients in the two groups were compared. Results After treatment, the scores of Athens insomnia scale (AIS) and Pittsburgh sleep quality index (PSQI) in the two groups decreased to different degrees, and the scores of AIS and PSQI in the observation group were lower than those in the control group, and the differences were statistically significant (P < 0.05). Before treatment, there was no difference in total sleep time (TST), rapid eye movement sleep period (REM), and sleep stage Ⅲ-Ⅳ (S3-S4) between the two groups (P > 0.05). After treatment, TST, REM and S3-S4 of patients in the two groups were prolonged to varying degrees, and the TST, REM and S3-S4 of patients in the observation group were longer than those in the control group, and the differences were statistically significant (P < 0.05). There was no significant difference in adverse reactions between the two groups (P > 0.05). Conclusion Exercise training combined with acupuncture at meridian selection points can effectively improve the sleep quality of patients with PI, and has certain safety.