Neural remodeling is the key to neurological recovery after intracerebral hemorrhage (ICH). The early stage of stroke is a sensitive period for brain plasticity, during which the brain initiates complex processes such as neurogenesis, synaptic remodeling, and angiogenesis to promote collateral circulation and achieve structural and functional remodeling. Acupuncture, a critical therapy in traditional Chinese medicine for treating brain disorders, has demonstrated significant efficacy in promoting neurological recovery after ICH in both clinical and experimental studies. However, systematic reviews of the mechanisms by which acupuncture regulates neural remodeling after ICH remain limited. For the first time, this review provides a multi-dimensional summary of the mechanisms by which acupuncture facilitates neural remodeling after ICH, including: (1) promoting neurogenesis and synaptic remodeling, (2) modulating the damaged microenvironment, (3) optimizing neuroelectrophysiology, (4) improving hemodynamics, and (5) facilitating angiogenesis. By systematically summarizing these mechanisms, this review highlights the therapeutic potential of acupuncture and aims to advance its further research and application in the field of neuroscience.