Objective To analyze the clinical effect of plum-blossom needle combined with western medicine in the treatment of alopecia areata. Methods A total of 80 patients with alopecia areata admitted to Mengyin County People 's Hospital from January 2020 to December 2023 were randomly divided into reference group and experimental group, with 40 patients in each group. The control group was treated with conventional western medicine, and the experimental group was treated with plum-blossom needle on the basis of the control group. The growth of vellus hair and terminal hair, therapeutic effect and adverse reactions were compared between the two groups. Results The density of vellus hair and final hair in the experimental group was higher than that in the reference group at 4, 8 and 12 weeks of treatment, and the difference was statistically significant (P <0.05). The total effective rate of treatment in the experimental group was 97.50%, which was higher than 82.50% in the reference group, and the difference was statistically significant (P <0.05). The incidence of adverse reactions in the experimental group was 5.00%, which was lower than 20.00% in the reference group, the difference was statistically significant (P <0.05). Conclusion On the basis of conventional western medicine treatment in patients with alopecia areata, the combination of plum-blossom needle therapy is helpful to promote the growth of vellus hair and terminal hair, improve the therapeutic effect and reduce the incidence of adverse reactions.