Objective To observe of the effect of neurophysiological facilitation of respiration combined with external diaphragm pacing on the respiration of stroke survivors. Methods Sixty-four stroke survivors were divided randomly into a treatment group and a control group, each of 32. Both groups were given routine drugs, while the treatment group was additionally provided with an external diaphragm pacemaker. Those in the treatment group also received neurophysiological facilitation of respiration six times a week for 3 weeks. Before and after the treatment, ar-terial oxygen partial pressure (PaO2) was measured in both groups along with arterial carbon dioxide partial pressure (PaCO2), arterial oxygen saturation ( O2sat) and C-reactive protein (CRP). Ultrasonography was used to measure diaphragm mobility at the end of expiration and inspiration (Δm) , diaphragm mobility of the end of forced inspiration and expiration ( ΔM), and the difference of diaphragm thickness ( Δd). First second forced expiratory volume ( FEV), and maximum voluntary ventilation (FVC) were also measured. Results After the treatment, the average PaO2, PaCO2, O2sat, CRP, Δm, ΔM, FEV and FVC of the treatment group were all significantly better than before the treatment and better than those of the control group. Conclusion Neurophysiological therapy combined with an external diaphragm pacemaker can significantly improve the respiration of stroke survivors, reducing the risk of lung infection.