Objective To explore the therapeutic efficacy and mechanism of acupuncture at Lieque (列缺 LU 7) in treatment of cervical vertigo (CV). Methods Forty CV patients met the inclusion criteria were enrolled and treated with acupuncture at bilateral LU 7 points, once daily with 10 times as a course. The changes of blood flow velocity in bilateral vertebral artery and basilar artery were observed through transcranial doppler sonography (TCD) before treatment, after deqi with acupuncture and after a course of treatment, respectively. The scores and therapeutic efficacy on clinical symptoms were assessed according to CV symptoms and the functional assessment scale as well as the Criteria-for Diagnosis and Curative Effect in TCM Syndromes before treatment and after a course of treatment. Results Before treatment, after deqi and after a course of treatment, the blood flow velocity of basilar artery (BA), left vertebral artery (LVA) and right vertebral artery (RVA) in 22 patients with a decreased blood flow velocity were respectively 23.20±4.84 vs 26.30 ± 4.17 vs 29.20 ± 4.20 (mm/s, BA), 21.65 ± 3.62 vs 24.20 ± 2.89 vs 26.40 ± 3.62 (mm/s, LVA) and 21.90±3.04 vs 24.25±3.01 vs 26.50_±3.95 (mm/s, RVA), while in 18 patients with an increased blood flow velocity were respectively 39.94 ± 8.24 vs 35.17 ± 4.84 vs 32.06 ± 3.49 (mm/s, BA), 41.83 ± 5.64 vs 37.28 ± 2.32 vs 35.61 ± 2.09 (mm/s, LVA) and 37.11 ± 9.83 vs 32.22 ± 6.13 vs 28.11 ± 4.12 (mm/s, RVA). Except that the difference of blood flow velocity of RVA was not significant in patients with an increased blood flow velocity before treatment and after deqi (P 〉 0.05), the Vm of all vessels in 40 patients was improved after deqi with acupuncture and a course of treatment (P〈0.01, P〈0.05). According to CV symptoms and the functional assessment scale, before treatment and after a course of treatment, the scores were 15.68 ± 5.35 and 26.30 ± 3.76, respectively, indicating that after a course of tre