Objective To determine the efficacy of micro-needle knife therapy versus placebo （sham micro-needle knife） for cervicogenic headache. Method A total of 60 eligible patients with cervicogenic headache were assigned to two groups with 30 cases in each group by using a random number table. Treatment group received micro-needle knife therapy and placebo group received sham micro-needle knife. Results After 4 weeks of intervention， the pain index score was significantly lower in the treatment group （1.27 ± 0.583） than that of the placebo group （3.37 ± 0.765）； the cervical range of motion was significantly lower in the treatment group A （1.20 ± 0.407） than that of the placebo group （2.47 ± 0.681）； the headache duration was significantly lower in the treatment group （3.33 ± 0.661） than that of the placebo group （5.30 ± 0.988）； the headache frequency was significantly lower in the treatment group （1.50 ± 0.682） than that of the placebo group （2.73 ± 0.691）， and the differences in the data of the two groups were statistically significant. The duration of headache （3.93 ± 0.739） and frequency of headache （1.96 ± 0.556） were significantly lower in the treatment group than that of the placebo group at follow-up， and the difference was statistically significant （P < 0.05）. The occurrence of adverse reactions was not statistically significant in the two groups（P > 0.05） Conclusions Micro-needle knife therapy could effectively improve the pain level of cervicogenic headache patients， reduce the headache duration and headache frequency， and improve the mobility of cervical spine. Acupuncture-related adverse events during treatment were infrequent in both groups and it′s safe for cervicogenic headache.