Objective: To explore the therapeutic effect of warm needling combined with transcutaneous vagus nerve stimulation (tVNS) on patients with post-stroke shoulder pain. Methods: A total of 126 patients with post-stroke shoulder pain were selected as the research subjects, and they were classified into an observation group (n = 63) and a control group (n = 63) based on treatment methods. The control group underwent conventional acupuncture, whereas the observation group received combined therapy with tVNS and warm needling; both groups were treated for 3 weeks. The upper-extremity function [Fugl-Meyer Assessment–Upper Extremity (FMA-UE) score, Modified Barthel Index (MBI)], upper limb pain and disability index [Visual Analogue Scale (VAS) score, modified Rankin Scale (mRS) score], shoulder passive range of motion (PROM), and sleep quality [Pittsburgh Sleep Quality Index (PSQI)] were compared between the two groups before and after treatment. Results: After treatment, the FMA-UE score, MBI score, forward flexion, back extension, abduction, external rotation, and internal rotation of shoulder PROM were increased in the two groups compared with those before treatment (P < 0.05), and the above indexes in the observation group were higher (P < 0.05). After treatment, the VAS score, mRS score, and PSQI score in the two groups were lower compared with those before treatment (P < 0.05), and the observation group exhibited lower scores (P < 0.05). Conclusion: Warm needling combined with tVNS exhibits relatively good efficacy in the treatment of post-stroke shoulder pain. It can help promote upper extremity recovery, increase the self-care ability of daily life, increase the shoulder passive range of motion, relieve pain, and improve sleep quality.