Abstract: Objective To investigate the effect of manipulation plus acupuncture in the treatment of vertebral artery type cervical spondylosis (CSA) and its influences on hemodynamics. Methods One hundred and sixty CSA patients were selected from January 2014 to June 2017 in our hospital, and they were randomly divided into observation group and control group, with 80 cases in each group. The control group was treated with manipulation, and the observation group was treated with manipulation plus acupuncture.The clinical efficacy of the two groups was observed and compared. The hemodynamic changes before and after treatment were compared between the two groups. Results The total effective rate of the observation group was significantly higher than that of the control group (95.0% vs 77.5%, P=0.001), and no serious adverse event was observed. The Vs, Vm and EDV in two groups significantly increased after treatment (all P < 0.05), and they were significantly higher in observation group than those in the control groupVs:(61.3±10.4) cm/s vs (50.8±8.6) cm/s; Vm:(45.6±9.2) cm/s vs (33.8±8.7) cm/s; EDV:(18.6±3.2) cm/s vs(16.4±2.8) cm/s; all P < 0.05. The PI and RI in two groups decreased significantly after treatment (all P < 0.05), and they were significantly lower in observation group than those in the control groupPI:(0.4±0.1) vs (0.6±0.2); RI:(0.3±0.1) vs(0.5±0.1); P < 0.05, respectively. The whole blood viscosity, plasma viscosity and erythrocyte aggregation index of the two groups after treatment were significantly lower than before treatment (all P< 0.05), and they were significantly lower in observation group than those in the control group (all P< 0.05). After treatment, vertigo, headache, neck pain, daily life and work, psychological and social adaptation ability improved significantly in both two groups (all P< 0.05), and they were superior in observation group compared to control group (all P < 0.05). Conclusion Manipulation combined with acupuncture is effective on CSA patients, and it can effectively improve the hemodynamic changes and blood circulation.