Objective: To examine the long-term effect of auricular therapy using magnetic pearls administered for the elderly suffering from insomnia. Design: A follow-up study after a randomized controlled trial. Settings: Four hostels for the elderly in Hong Kong. Interventions: This paper focuses on reporting the long-term effect of auricular therapy using magnetic pearls in the experimental group of a randomized controlled study. Fifteen volunteer participants were followed up at 1-, 3-, and 6-month intervals after a 3-week treatment course. Outcome measures: Objective sleep parameters using actigraphic monitoring were collected at different intervals of time after the therapy. Results: Results of RANOVA demonstrate that there was a significant difference of nocturnal sleep time ( F 2.30,29.90=3.63, P<0.05) and marginally differences of sleep efficiency ( F 4,52=2.52, P=0.05) at baseline, immediately after the therapy, and at the three time intervals at 1, 3 and 6 months. The results illustrate that the mean nocturnal sleep time ( F=4.95, P=0.30, R 2=0.91) and the mean sleep efficiency ( F=13.50, P=0.19, R 2=0.96) also remained constant over the 6-month follow up period. The results of least square polynomial regression analysis also illustrate that the mean NST ( F=4.95, P=0.30, R 2=0.91) and the mean sleep efficiency ( F=13.50, P=0.19, R 2=0.96) remained constant over the 6-month follow up period. Conclusion: The results of this follow up study indicate that auricular therapy using magnetic pearls could have a long-term effect, at least within the observed period of time, on improving the quality as well as the quantity of sleep among the elderly.