This study aims to investigate the therapeutic efficacy and complications of low-frequency acupuncture therapy based on the Midnight-Noon Ebb-Flow concept in central neurogenic bladder (CNB).This study was a prospective, randomized controlled trial. Sixty patients diagnosed with CNB without prior treatment were randomly divided into two groups: the control group (n = 30) was treated with basic rehabilitation training, and the treatment group (n = 30) was treated with basic rehabilitation training plus low-frequency acupuncture therapy based on the Midnight-Noon Ebb-Flow concept for 4 weeks. The fixed acupuncture points selected were: Sanyinjiao (bilateral), Zhongji (unilateral), and Diji (unilateral). The study compared pre- and post-treatment clinical curative effects, urodynamic indicators, urination status, the Neurogenic Bladder Symptom Score (NBSS), the Urinary Symptom Distress Scale (USDS), the World Health Organization Quality of Life Brief Inventory (WHOQOL-BREF), and the occurrence of adverse reactions and complications between the two groups.The overall efficacy rate of 96.67% in the treatment group was significantly higher than that in the control group (86.67%) (P 0.05).Low-frequency acupuncture therapy based on the Midnight-Noon Ebb-Flow concept significantly improves bladder function and alleviates urinary difficulties in CNB, demonstrating good safety and considerable clinical applicability.