〔Abstract〕 Objective To observe the curative effect of acupuncture on hand sanyang meridians with millifire needle combined with biofeedback therapy in the treatment of hand dysfunction after stroke. Methods A total of 96 stroke patients treated in Shenzhen Luohu District Hospital of Traditional Chinese Medicine from August 2020 to December 2022 were selected and randomly divided into a control group, a conventional acupuncture combined group and a millifire needle acupuncture combined group by random number table method, with 32 cases each group. Patients in the conventional acupuncture combined group were treated with conventional acupuncture combined with biofeedback therapy, patients in the millifire needle acupuncture combined group were treated with millifire needle acupuncture combined with biofeedback therapy, and patients in the control group were treated with simple biofeedback therapy. Electromyogram (EMG) value, Lindmark score and China stroke scale (CSS) were used to evaluate the efficacy before and after treatment. Results (1) After treatment, the ENG value of the three groups were all higher than those before treatment, and after treatment, the EMG value of the conventional acupuncture combined group was higher than that of the control group, and the EMG value of the millifire needle acupuncture combined group was higher than that of the conventional acupuncture combined group, the differences were statistically significant (P < 0.05). (2) After treatment, lindmark wrist and total scores of the three groups were higher than those before treatment, and after treatment, lindmark wrist score and total score of the patients in the conventional acupuncture combined group were higher than those in the control group, while the scores of patients in the millifire needle acupuncture combined group were higher than those in the conventional acupuncture combined group, the differences were statistically significant (P < 0.05). The lindmark finger scores of patients in the conventional acupuncture combined group and the millifire needle acupuncture combined group were higher than those before treatment, and the lindmark finger score of patients in the millifire needle acupuncture combined group was higher than that in the conventional acupuncture combined group after treatment, the differences were statistically significant (P < 0.05). After treatment, the grasping score of the millifire needle acupuncture combined group was higher than that before treatment, and the grasping score of the millifire needle acupuncture combined group was higher than those in the conventional acupuncture combined group and the control group, with statistical significance (P < 0.05). (3) After treatment, the CSS scores of the three groups were all lower than those before treatment, and after treatment, the CSS scores of the patients in the conventional acupuncture combined group were lower than that in the control group, while in the millifire needle acupuncture combined group were lower than that in the conventional acupuncture combined group, with statistical significance (P < 0.05). Conclusion Patients with hand dysfunction after stroke can effectively improve the recovery of hand motor function by acupuncture the hand Sanyang meridian with millifire needle needle combined with biofeedback.