Abstract: Hemiplegia is a common sequel of stroke, primarily characterized by motor dysfunction on one side of the body. According to the theory of meridian and tendon intersection, meridians and tendons originating from one side of the head cross over to regulate functions on the contralateral side of the body. The interhemispheric inhibition theory describes the inhibitory influence exerted by one cerebral hemisphere over the other. This article suggests that the crossing patterns of vascularized meridians and interhemispheric inhibition share similarities in both physiological regulation. Stroke often results in meridian-tendon impairment and interhemispheric inhibition, hindering the recovery of motor function after stroke. The opposing needling, one of the nine ancient needling techniques, operates on the principle of “treating the right side when the left is affected, and vice versa”, aiming to regulate qi, blood, yin, and yang. Based on the different clinical manifestations of hemiplegia in the flaccid paralysis, spastic, and recovery stages, opposing needling is applied according to the meridians and locations identified. During the flaccid paralysis stage, treatment focuses on unblocking the Governor Vessel and regulating mental functions, as well as harmonizing yin and yang. In the spastic stage, the therapeutic aim is to relax the meridians and tendons and promote joint mobility. In the recovery stage, the intervention emphasizes regulating the internal organs and restoring the balance of qi and blood.