To observe the efficacy of acupuncture combined with transcranial direct current stimulation(tDCS) in the treatment of post-stroke vascular cognitive impairment and the effects on the levels of homocysteine(Hcy)，neuron-specific enolase(NSE) and brain-derived neurotrophic factor(BDNF).Methods:A total of 102 patients with ischemic stroke with cognitive impairment，admitted to the Department of Rehabilitation of Shaanxi Provincial People's Hospital from November 2021 to November 2022，were selected as the research subjects.The patients were randomly divided into acupuncture combination group(34 cases，with 2 dropouts)，tDCS combination group(34 cases，with 1 dropout) and Western medicine group(34 cases).The treatment lasted for 4 weeks.Results:After treatment，the Montreal cognitive score，Lowenstein Occupational Therapy Cognitive Assessment(LOTCA) score，Barthel Index score and serum BDNF of the combined acupuncture group were significantly increased(P<0.05) and higher than those of the other two groups.The Behavioral Memory Test scores of the acupuncture combination group and tDCS group were significantly higher(P<0.05) than those of the Western medicine group.After the treatment，the serum Hcy and NSE levels of all three groups were significantly reduced，with the acupuncture combination group being significantly lower than the other two groups(P<0.05).Conclusion:The combination of acupuncture and tDCS treatment can significantly improve the cognitive function，enhances daily activity abilities，and improves the quality of life in patients with stroke with cognitive impairment.