Objective To observe the effect of Xingnao Kaiqiao Acupuncture on cognitive impairment post stroke. Methods Fifty-four patients from July, 2013 to December, 2015 with cognitive impairment post stroke were randomly divided into experimental group (accepted Xingnao Kaiqiao Acupuncture and repetitive transcranial magnetic stimulation) and control group (repetitive transcranial magnetic stimulation only). They were assessed with Mini-Mental State Examination (MMSE) and Montreal Cognitive Assessment (MoCA) before and 4 weeks after treatment. Results The scores of MMSE and MoCA improved after treatment in both groups (t>3.52, P<0.01), and improved more in the experimental group than in the control group (t>2.29, P<0.05). Conclusion Xingnao Kaiqiao Acupuncture may further improved the recovery of cognitive impairment post stroke based on repetitive transcranial magnetic stimulation.