Abstract：Objective To observe the clinical efficacy of abdominal acupuncture combined with acupoint catgut embedding in treating pediatric tic disorders with spleen deficiency and liver hyperactivity syndrome, and to explore its mechanism of action.  Methods A total of 80 children with tic disorder of the spleen deficiency and liver hyperactivity type who attended the department of acupuncture at Shanghai Zhongye Hospital and the department of acupuncture at Shanghai Jiading District Hospital of Traditional Chinese Medicine from July 2023 to March 2025 were selected as the study subjects. A random sequence was generated using SAS 9.4 software, and the participants were allocated to a treatment group and a control group at a ratio of 1∶1, with 40 cases in each group. The treatment group received abdominal acupuncture combined with acupoint embedding therapy, while the control group received scalp acupuncture therapy. The Yale Global Tic Severity Scale （YGTSS） scores and Traditional Chinese Medicine （TCM） syndrome scores before and after treatment were compared between the two groups. Results After treatment, the YGTSS scores and TCM syndrome scores in both groups decreased compared with those before treatment, and the scores in the treatment group were lower than those in the control group, with statistically significant differences between the groups （t＝14.70, 5.22; both P＜0.05）. The total effective rate in the treatment group was 92.5% （37/40）, which was significantly higher than 87.5% （35/40） in the control group, with a statistically significant difference between the groups （χ2＝5.08, P＜0.05）. Conclusion Abdominal acupuncture combined with acupoint embedding therapy can effectively improve various symptoms in children with tic disorder of the spleen deficiency and liver hyperactivity type, and reduce YGTSS scores and TCM syndrome scores.