Post-stroke depression is the most common mental complication after stroke, seriously affecting the recovery of neurological function and quality of life of patients. Although antidepressants are currently the first-line treatment, they have limitations such as cardiotoxicity, gastrointestinal reactions and relatively high cost. Auricular therapy, as a non-pharmaceutical intervention method integrating traditional Chinese medicine and modern neuroanatomy, has shown unique advantages in the treatment of PSD through a multi-target regulatory mechanism. From the perspective of neurobiology, this article systematically reviews the mechanism of auricular therapy in the intervention of PSD, mainly including: (1) Regulating the homeostasis of monoamine and amino acid neurotransmitters; (2) Promote neural plasticity and the reorganization of brain network functions; (3) Inhibit neuroinflammation and oxidative stress responses; (4) Regulate the neuroendocrine system. The aim is to comprehensively explain the mechanism by which auricular therapy alleviates PSD through a multi-dimensional regulatory network of "neuro-immune-endocrine", and topromote further research and application of auricular therapy in the treatment of post-stroke depression.