To analyze the effectiveness and related factors of orbital electroacupuncture in the treatment of abducens nerve palsy following ischemic stroke. Methods: We summarized the clinical data of patients from January 2013 to June 2019 who suffered abducens nerve palsy following ischemic stroke and were treated with intraorbital electroacupuncture. Complete recovery was set as the outcome indicator. Factors such as gender, age, disease duration, number of treatments, blood pressure, blood lipid, and homocysteine (Hcy) were analyzed and compared between the recovered patients and non-recovered patients. Results: A total of 112 patients meeting the inclusion criteria were enrolled in this study, including 34 cured patients, 55 patients with improvement, and 23 patients without improvement; the overall effectiveness was 79.47%. The median maximal diplopia angle before and after treatment was 18.25° and 7.03°, respectively, and the median ocular position score before and after treatment was 2 and 1, respectively; the differences in values before and after treatment were statistically significant (P< 0.01). Compared to non-recovered patients, recovered patients experienced milder abducens nerve palsy, a shorter disease duration, a greater number of treatments, and a smaller proportion of recovered patients with hypertension, hyperlipidemia, ischemic heart disease, and hyperhomocysteinemia (HHcy); these results were statistically significant (all P<0.05). Multivariate logistic regression analysis showed that the severity of abducens nerve palsy, disease duration, and HHCy were risk factors of treatment effectiveness (P=－1.763, P=0.001; β=－0.038, P=0.013; β=－2.782, P=0.000), and the number of acupuncture sessions was a protective factor (β=0.060, P=0.002). Conclu? sion: Intraorbital electroacupuncture can improve or even eliminate diplopia and eye movement disorders in patients with abducens nerve palsy following ischemic stroke, and it promotes functional recovery after abducens nerve palsy. The curative effect is influenced by factors including the disease duration, number of treatments, severity of the palsy, and HHcy.