Objective To investigate the efficacy of filiform needle fire acupuncture plus pricking-cupping bloodletting in treating acute ankle sprain in adolescent students.Method One hundred adolescent student outpatients with acute ankle sprainwere randomly allocated to treatment and control groups, 50 cases each.The treatment group received filiform needle fire acupuncture plus pricking-cupping bloodletting at the most obviouspart of ankle tenderness once every other day. The control group received routine protection, a rest, ice compress,compressionand affected limb elevation.Swelling severitywas examined and the AOFAS Ankle Hindfoot Scalescore and the VAS score were recorded at study entry, and one, three and five days and two, four and eight weeks after treatment.Result Swelling severityand the ankle pain score improved in both groups after treatment (P<0.05) and the post-treatment score was lower in the treatment group than in the controlgroup(P<0.05). The total efficacy rate was 100% (50/50) in the treatment group, which was higher than 80% (40/50) in the control group (P<0.05).Conclusion Filiform needle fire acupuncture plus pricking-cupping bloodletting is a better way to treat acute ankle sprain.It can relieve the pain and swelling in short time, shorten treatment time and restore ankle activity in short time to reduce theoccurrence of sequelae.