This article is the protocol of a randomized controlled trial to assess the efficacy and safety of electroacupuncture (EA) combined with a microneedling knife in moderate to severe allergic rhinitis (AR). AR is a hypersensitivity disorder that significantly worsens the quality of life, affecting patients' daily life, studies, sleep and mood. Conventional AR treatment is suboptimal, so the study is looking for simpler, more convenient and cost-effective alternatives. The study includes 90 patients randomly divided 1:1 into the EA with microneedle knife group and the drug group, with a 4-week treatment period and a 3-month follow-up. Assessments will take place at weeks 0, 2, 4, 8 and 16. The primary outcome is Total Nasal Symptom Score (TNSS), secondary outcomes include Non-Nasal Symptom Score (TNSS), Rhinitis Quality of Life Questionnaire (RQLQ), serum levels of eotaxin, ICAM-1 and eosinophil cationic protein (ECP). The study will evaluate all adverse events and is registered under NCT06890260.