Objective: To observe the clinical effects of ZHAO's thunder-fire moxibustion in the treatment of insomnia in heart-spleen deficiency. Methods: 70 patients were randomly divided into two groups, 35 cases in the treatment group, managed by thunder-fire moxibustion and acupuncture, 35 cases in the control group, managed by single acupuncture treatment. Results: The results showed cure in 8 cases, remarkable effect in 15 cases, effect in 10 cases, failure in 2 cases and the total effective rate in 91.4% in the treatment group, and cure in 4 cases, remarkable effect in 11 cases, effect in 11 cases, failure in 9 cases, and the total effective rate in 74.2% in the control group. The difference is statistically significant in comparison of the total effective rates between the two groups (P<0.05). Conclusion: Thunder-fire moxibustion gives a better therapeutic effect in the acupuncture treatment of insomnia in heart-spleen deficiency. © Shanghai Research Institute of Acupuncture and Meridian and Springer Berlin Heidelberg 2010.