Abstract: Academician Tong Xiaolin divided the human body into top, upper, middle and lower jiao in combination with modern anatomy, and proposed the concept of "top jiao pulse", that is, the pulse at or above the wrist transverse stripe. This paper analyzes the shape, trend, state and clinical application of the "top jiao pulse"; believes that the proposal of the "top jiao pulse" has important clinical application value for the severity and prognosis of diseases in the top jiao area, such as cervical thyroid disease, cervical spondylosis, carotid plaque, cerebrovascular disease, etc; emphasizes that there are both connections and differences between disease pulse diagnosis and state pulse diagnosis. When a disease develops to a certain extent and appears in a state, the disease and state should be mutually involved. The proposal of "top jiao" and "top jiao pulse" is a supplement and improvement to the theory of Cunkou sphygmology, which will greatly enrich the theory of traditional Chinese medicine pulse.