Introduction: In this study, we investigated whether neurofeedback (NFB) training and swimming exercise would decrease the electroencephalographic (EEG) changes and visual image-induced craving in methamphetamine (METH)-dependent patients. Methods: This study was a randomized controlled trial design. 32 METH-dependent patients were allocated randomly to four groups; control, NFB, Swim, and NFB/Swim. The EEG and visual image-induced craving were recorded before and after the intervention in all four groups. Results: We found that the NFB, Swim, and NFB/Swim groups showed significantly lower absolute power for 4 frequency bands. Also, the swim and NFB/Swim groups had less and greater relative power in the alpha and delta bands, respectively. In addition, NFB/Swim group exhibited an increase in delta/alpha power ratio than the control and the NFB groups. Also, the NFB/Swim group showed a significant reduction in visual image-induced craving score than the control, swim, and NFB groups. Conclusion: This study provides novel evidence that the NFB training along with swimming exercise during METH-abstinence was effective in the normalization of METH-induced EEG changes, which may help patients to manage their cravings.