Objective This study was conducted to compare the efficacy of acupuncture, moxibustion and electro-acupuncture on guinea pig models of cochlear endolymphatic hydrops. Methods Fifty healthy male guinea pigs (body weight 200-250 g) were randomly divided into five groups: the normal group, model group, acupuncture group, moxibustion group, and electro-acupuncture group (n=10 in each group). Forty guinea pigs received a once-daily intraperitoneal injection of aldosterone in a dose of 100 μg/100 g/d for 5 days to induce endolymphatic hydrops. After a 2-month interval, the animals of the acupuncture, moxibustion and electro-acupuncture groups were treated with corresponding acupoints stimulation at points Baihui (GV 20) and Tinggong (SI 19) once a day for 10 days, respectively. We measured the hearing threshold of the auditory brainstem response (ABR) and evaluated pathologically the degree of hydrops using hematoxylin-eosin staining, and then the ratio of scala media (SM) area/[SM + scala vestibuli (SV) area] was calculated. Results 1. The hearing threshold of ABR in the acupuncture, moxibustion and electro-acupuncture groups were all significantly lower than that of the model group (P<0.01). The ABR threshold in the electro-acupuncture group was significantly decreased in comparison with that of the acupuncture and moxibustion groups (P<0.01 for both). The hearing threshold of the moxibustion group was significantly lower than that of the acupuncture group (P<0.05). 2. The ratio of SM/(SM + SV) in the acupuncture, moxibustion and electro-acupuncture groups were all significantly lower than that of the model group (P<0.01). The ratio in the electro-acupuncture group was significantly decreased in comparison with that of the acupuncture and moxibustion groups (P<0.01, P<0.05). The ratio of the moxibustion group was significantly lower than that of the acupuncture group (P<0.01). Conclusions Our findings suggest that all acupuncture, moxibustion and electro-acupuncture at the acupoints Baihui (GV 20) and Tinggong (SI 19) can significantly suppress the development of endolymphatic hydrops and improve the cochlear function in guinea pigs. Electro-acupuncture is the most effective in this experiment, and moxibustion therapy shows better effect than acupuncture.