Objective To explore the necessity and effectiveness of type-based acupuncture treatment for cervical spondylosis. Method Two hundred and forty patients with clinically common cervical spondylosis, cervical spondylotic radiculopathy or cervical spondylotic vertebral arteriopathy, 80 cases each type, were enrolled. Every type of patients was randomly allocated to observation and conventional groups. The observation group (120 patients) received type-based acupuncture treatment. Cervical spondylosis was treated by syndrome differentiation; cervical spondylotic radiculopathy, from the spleen and stomach; cervical spondylotic vertebral arteriopathy, with nape five-needle acupuncture. Every type of the conventional group (120 patients) received the same therapeutic method (conventional selection of acupoints). Before and after five and ten sessions of treatment, cervical spondylosis and cervical spondylotic radiculopathy were scored using the CSAS and the VAPS and cervical spondylotic vertebral arteriopathy was scored using the ESCV. The overall therapeutic effects were evaluated after ten treatments. Result Of the patients with cervical spondylosis, there were statistically significant pre-/post-treatment differences in the CSAS and VAPS scores in the two groups (P<0.05, P<0.01) but no statistically significant differences in the scores between the groups (P>0.05). Of the patients with cervical spondylotic radiculopathy, there were statistically significant differences in the CSAS and VAPS scores in the two groups after five treatments compared with before (P<0.05) but no statistically significant differences in the scores between the groups (P>0.05);after ten treatments there were statistically significant differences in the scores in the two groups compared with before (P<0.01) and also between the groups (P<0.05). Of the patients with cervical spondylotic vertebral arteriopathy, there was a statistically significant difference in the ESCV score in the observation group after five treatments compared with before (P<0.01);the score also decreased in the conventional group (P<0.05);there was a statistically significant difference between the groups (P<0.05);after ten treatments there was a statistically significant difference in the ESCV score in the two groups compared with before (P<0.01) and also between the groups (P<0.05). After ten treatments, the cure and marked efficacy rate and the total efficacy rate were 76.6%and 92.8%, respectively, in the observation group and 54.2%and 86.0%, respectively, in the conventional group. There was a statistically significant difference in the cure and marked efficacy rate between the two groups (P<0.01). Conclusion Type-based acupuncture can markedly improve the clinical therapeutic effect on cervical spondylosis.