Objective To explore the improvement effect of electroacupuncture combined with lower limb isokinetic muscle strength training on balance function and lower limb symmetry in patients with stroke, and to provide a basis for clinical rehabilitation intervention. Methods Ninety patients with stroke who received rehabilitation treatment in Xiaoshan District Hospital of Traditional Chinese Medicine from January 2022 to December 2024 were randomly divided into a control group and an observation group, with 45 patients in each group. The control group received routine rehabilitation and lower limb isokinetic muscle strength training, while the observation group received combined electroacupuncture treatment on the basis of control group, 6 weeks for a course. The Berg balance scale (BBS), Fugl-Meyer balance scale (FM-B), lower limb isokinetic muscle strength (peak torque (PT), average power (AP), peak torque ratio of affected side to unaffected side (L/R ratio)), and Modified barthel index (MBI) total score and scores for each dimension before and after treatment were compared between the two groups. Results After 6 weeks of treatment, the BBS score, FM-B score, PT, AP, L/R ratio, and the total and dimensional scores of the MBI were significantly improved in both groups compared with before treatment, and the improvements in the observation group were significantly greater than those in the control group, with statistically significant differences (all P＜0.05). Conclusion Electroacupuncture combined with lower limb isokinetic muscle strength training can significantly improve balance function, lower limb muscle strength symmetry, and promote the recovery of self-care ability in patients with stroke. The mechanism may be achieved through the synergistic effect of enhancing central nervous system plasticity and peripheral muscle group control ability.