Objective To investigate the effect of head and body acupuncture combined with sodium hyaluronate eye solution on moderate and severe dry eye.Methods Sixty-two patients with moderate and severe dry eye treated from November 2021 to March 2023 were prospectively selected and randomly divided into study group and control group, with 31 cases in each group. The control group was treated with sodium hyaluronate eye solution, and the study group was treated with head and body acupuncture on the basis of the control group. TCM syndrome score, ocular symptom score, relevant indexes of tear film stability, clinical efficacy, meibomian gland secretion capacity, tear cytokines and adverse reactions were compared between the two groups.Results The difference of TCM syndrome scores of primary and secondary symptoms in the study group before and after treatment was higher than that in the control group (P < 0.05). The difference of ocular surface disease index and ocular surface fluorescence score before and after treatment in the study group were higher than those in the control group (P < 0.05). The differences of lacrimal secretion test, lacrimal river height, non-invasive tear film rupture time and lipid layer thickness before and after treatment in the study group were higher than those in the control group (P < 0.05). The total effective rate of the study group was higher than that of the control group (P < 0.05). The secretion capacity of meibomian gland in the study group was higher than that in the control group (P < 0.05). The differences of lysozyme, epidermal growth factor and lactoferrin in the study group before and after treatment were higher than those in the control group (P < 0.05). There were no obvious adverse reactions in the two groups during treatment.Conclusion Head and body acupuncture combined with sodium hyaluronate eye solution is effective in the treatment of moderate and severe dry eye, which can significantly improve ocular symptoms and related indexes of tear film stability, enhance the secretion capacity of meibomian gland, and promote the secretion of lysozyme, epidermal growth factor and lactoferrin, which is safe and reliable.