To observe the effect of acupoint catgut embedding on histopathological changes of gastric mucosa and expression of mucosal hypoxia inducible factor (HIF)-1α and vascular endothelial growth factor (VEGF) proteins in chronic atrophic gastritis (CAG) rats, so as to explore its mechanisms underlying improvement of CAG. Male SD rats were divided into blank group (n=10) and model group (n=9) and catgut embedment group (n=10). The CAG model was established by free drinking of N-methyl-N'-nitro-N-nitroso-guanidine solution (100 μg/mL) and irregular diet. Catgut embedment was applied to "Zhongwan" (CV12) and bilateral "Zusanli" (ST36) and "Pishu" (BL20), once every 10 days, 6 times in total. Histopathological changes of gastric mucosal tissue were observed under microscope after H.E. staining. The expression of HIF-1α and VEGF proteins in the antrum of stomach was detected by Western blot. H.E. staining showed that compared with the blank group, the number of rats with glandular necrosis, atrophy and mucosal stasis in the model group were increased significantly (P<0.001, P<0.05).Compared with the model group, the number of rats with gland necrosis, atrophy and mucosal stasis in the catgut embedment group were significantly reduced (P<0.01, P<0.05). Western blot displayed that the expression levels of HIF-1α and VEGF proteins were significantly higher in rats with blood stasis and model group than in those without blood stasis and the blank group (P<0.01), and were considerably down-regulated in the catgut embedment group than in the model group (P<0.05, P<0.01). Acupoint catgut embedment can improve the injury of gastric mucosa in CAG rats, which may be associated with its function in down-regulating the expression of HIF-1α and VEGF proteins in the gastric mucosa.