To investigate the therapeutic effect of scalp acupuncture combined with repetitive facilitation exercise (RFE) on lower limb motor dysfunction in hemiplegic patients. Methods: A total of 90 patients with stroke were randomly divided into RFE group (n=45) and control group (n=45) using a random number table method. The control group received scalp acupuncture and routine rehabilitation treatment while the RFE group received RFE during the retention period of scalp needle. All treatments were administered continuously for 6 weeks. Before and after treatments, the motor function of lower limbs was evaluated using the Fugl-Meyer assessment (FMA), the balance ability was evaluated using the Berg balance scale (BBS), the daily activity ability was evaluated using the modified Barthel index scale (MBI), and the walking ability was evaluated using the 10-meter maximum walking speed test (10MWT). Results: After 6 weeks of treatments, the BBS, 10MWT, MBI, and FMA scores in patients of both groups were significantly higher than those before treatment (P<0.01). The BBS, 10MWT, MBI, and FMA scores of the RFE group after treatment were significantly higher than those of the control group after treatment (P<0.01). Conclusion: The combination of scalp acupuncture and RFE demonstrated a better therapeutic effect than regular scalp acupuncture on lower limb motor function in hemiplegic patients.