With the unique structure and manipulation techniques of blood-letting and cutting, hook needle serves as a role in dredging meridians, removing blood stasis, purging heat for resuscitation and relaxing synechial tissues. There are three needling techniques of hook needle: swift pricking, bleeding and pricking. Six manipulations are commonly used as lifting-thrusting, plucking, pulling, pushing-scraping, vibration and massage. The mechanism and manipulations of hook needling are summarized systematically in the present paper. In this way, its manipulations, indications and contraindications are expounded in detail.