Objective To compare the therapeutic efficacy between warm needling and Pyridostigmine bromide in treating ocular myasthenia gravis, for seeking the optimal treatment method. Method Seventy patients with ocular myasthenia gravis were randomized into a treatment group intervened by warm needling and control group intervened by Pyridostingmine bromide, 35 in each group; meanwhile, fortified Yi Qi Tang decoction was given to both groups. The observation lasted 6 weeks and a 3-month follow-up was conducted. The clinical absolute and relative scoring system for myasthenia gravis, and the Chinese medicine syndrome scale for spleen-qi deficiency were adopted for quantitative comparison and efficacy evaluation. Result The total effective rate was 85.7% in the treatment group, higher than that in the control group. Conclusion Warm needling plus herbal medicine is effective in treating ocular myasthenia gravis.