To observe the efficacy in cervical headache of acupuncture combined with fire needling and the simple acupuncture therapy. One hundred and eighty cases were randomized into an acupuncture plus fire needling group (group A) and an acupuncture group (group B), 90 cases in each one. Baihui (GV 20), Wangu (GB 12), Fengchi (GB 20), Tianzhu (BL 10) and Neck-Jiaji (EX-B 2) were selected in the two groups. In group A, the fire needling technique was applied to all the above points before acupuncture with filiform needles. In group B, the acupuncture therapy was used only. The treatment was given once a day, the efficacy was compared between the two groups after 20 treatments. The total effective rate was 95.6% (86/90) in group A and was 84. 4% (76/90) in group B, indicating the significant difference in comparison (P<0.05). VAS were 7.44+/-1.26 and 0.73+/-l. 44 before and after treatment in group A separately, those were 7.56+/-1.07 and 2. 56+/-2. 99 in group B, indicating the significant difference in comparison (P<0.01). The difference in VAS after treatment was significant between the two groups. In group A, the follow-up visit was conducted at 3 months and 6 months after treatment for the cured cases. The total recurrence rate in the patients without bony pathological changes was 14.8% (4/27) and that in the patients with bony pathological changes was 43. 5% (10/23), there was significant difference between them (P<0. 05). The combined therapy of fire needling technique and filiform needle acupuncture improves the efficacy and sustains the efficacy especially on cervical headache without bony pathological changing.