Objective To observe the effect of continuous passive motion (CPM) combined with occupational therapy (OT) on upper limb motor function recovery after stroke and provide reference for clinical rehabilitation protocol optimization. Methods A total of 70 stroke patients treated in the Rehabilitation Department of Hangzhou Xiaoshan District Hospital of Traditional Chinese Medicine from August 2024 to August 2025 were randomly divided into a control group and an observation group, with 35 patients in each group. The control group received routine rehabilitation combined with CPM training, while the observation group additionally received OT. Both groups underwent 6 weeks of treatment. The upper limb motor function [Fugl-Meyer assessment for upper extremity (FMA-UE)], muscle tone [modified Ashworth scale (MAS)], range of motion (ROM), hand function and fine manipulation ability [Wolf motor function test (WMFT), action research arm test (ARAT)], and activity of daily living (ADL) of the two groups of patients were evaluated before and after treatment, respectively, and the differences in therapeutic effects between the two groups were compared. Results After treatment, all indicators improved significantly in both groups (all P＜0.05). The observation group demonstrated significantly greater improvements than the control group in FMA-UE (across all subdimensions and total scores), MAS, ROM, WMFT, ARAT and total scores of modified Barthel index (MBI) (all P＜0.05). Conclusion The combination of CPM and OT can effectively promote the recovery of upper limb motor function in stroke patients, improve spasticity and joint movement limitations, enhance fine motor skills of the hand and independence in daily life. This method is safe, feasible and can be promoted in clinical practice, providing an effective clinical pathway for the systematic rehabilitation of upper limb dysfunction after stroke.