Abstract: Objective To investigate the effect and mechanism of acupuncture combined core muscle training on early balance function of ischemic stroke patients with hemiplegia. Methods A total of 192 cases of ischemic stroke patients with hemiplegia were randomly divided into two groups, 96 cases in each group. The control group was given core muscle training, and the observation group was added Dialectical stage acupoints acupuncture based on control group. The trunk control ability (PASS score), lower limbs function (FMA score), balance ability (BBS score), walking ability (Holden score), life quality (SF-36 health questionnaire), Middle cerebral artery pulsatility index (PI), resistance index (RI) and mean blood flow velocity (Vm) of two groups were compared. Results After treatment, PASS score and FMA score of two groups were significantly increased (P<0.05), and PASS score and FMA score of observation group was significantly higher than control group (P<0.05). After treatment, BBS score and Holden score of two groups were significantly increased (P<0.05), and BBS score and Holden score of observation group were significantly higher than control group (P<0.05). The physiological function, physiological functions, body pain, health status, energy, social functions, emotional function, versus, mental health of observation group were lower than those of control group (P<0.05). After treatment, the RI and PI of two groups were significantly reduced (P<0.05), and the RI and PI of observation group were lower than that of control group (P<0.05); the Vm of two groups were significantly increased (P<0.05), and the Vm of observation group were higher than that of control group (P<0.05). Conclusion Acupuncture combined core muscle training could significantly improve the balance function and life quality of patients with ischemic stroke, and its mechanism may be related to the improvement of cerebral hemodynamics by dialectical stage acupoints acupuncture combined core muscle training.