To observe the effects of electroacupuncture (EA) at the“Zusanli”(ST36) acupoint on the pathology of the gastrocnemius muscle and inflammatory cytokines in a rat model of Intensive Care Unit-acquired weakness (ICU-AW), and to explore its therapeutic effects and potential mechanisms against ICU-AW. Methods: Forty-four male Sprague-Dawley (SD) rats were randomly divided into the control group (n=12), sham operation group (n=12), model group (n=10), and EA group (n=10). The ICU-AW rat model was established in the model and EA groups via cecal ligation and puncture (CLP). The sham operation group underwent laparotomy for exploration followed by closure. After successful modeling, the EA group received daily EA stimulation at bilateral Zusanli acupoints for 30 minutes per session, once a day, for 7 consecutive days. The survival status of rats in each group was observed post-operation. The rats were sacrificed on the 7th postoperative day to collect gastrocnemius muscle and serum samples. Body weight, gastrocnemius wet weight, and the sarcopenia index (SI) were measured. Pathological changes in the gastrocnemius muscle were observed using Hematoxylin and Eosin (HE) staining and Masson staining, while the muscle fiber cross-sectional area (CSA) and collagen volume fraction (CVF) were calculated. The levels of interleukin-1 β (IL-1 β), IL-6, and C-reactive protein (CRP) in the serum and gastrocnemius tissue were detected using enzyme-linked immunosorbent assay (ELISA). Results: (1) Compared with the sham operation group, the model group rats exhibited a poor general condition, weak resistance, and a high mortality rate (P<0.05). Their body weight, gastrocnemius wet weight, SI, and CSA were significantly decreased (P<0.05), while the levels of IL-1β, IL-6, CRP, and CVF in the serum and gastrocnemius tissue were significantly increased (P<0.05). Pathological examination revealed muscle fiber atrophy and massive accumulation of collagen fibers in the gastrocnemius muscle. (2) Compared with the model group, the EA group showed an increased survival rate (P<0.05). The body weight, gastrocnemius wet weight, SI, and CSA in the EA group were higher than those in the model group (P<0.05), while the levels of IL-1β, IL-6, CRP, and CVF in the serum and gastrocnemius tissue were lower than those in the model group (P<0.05). The degree of gastrocnemius muscle injury and collagen fiber accumulation in the EA group was lower than that in the model group. Conclusion: Electroacupuncture at the “Zusanli”acupoint may help delay gastrocnemius muscle atrophy in ICU-AW model rats. The mechanism may be related to the inhibition of inflammatory cytokine release and the reduction of collagen fiber formation.