This paper introduces the current diseases of acupuncture in Guyana and analyzes the typical cases and explains the way of practice innovation. The data in recent five years showed that main diseases were spine disorder and osteoarthritis in acupuncture clinic. The incidence of low back pain in spine disorder diseases was 71.8%, which was significantly higher than that of cervical spondylosis(28.2%). Knee osteoarthritis(KOA) had the highest proportion of the joint diseases, accounting for 45.6%. In the diagnosis and treatment of severe case of KOA, it was proposed to study the factors outside the knee, pay more attention to the focus points such as "tendon contracture" and "coalescence" of gallbladder meridian sinew in the waist and buttock. The Myofascial trigger points(MTrP) were treated with sparrow-pecking penetrated needling method of awn needle to reduce the pain of KOA and improve the abnormal gait. Intractable migraine case was suggested to be treated from the neck. It could reduce the frequency of migraine attack and reduce the degree of headache, treated with the rehabilitation method of penetrating the suboccipital MTrPs and fine adjustment of the upper cervical vertebra. In the case of long-term hemiplegia, the use of Lin's scalp acupuncture combined with motor imagination training could help stimulate the activity of neurons in the corresponding functional areas of the brain and achieve the improvement of the functional quality of hemiplegia. The practice of acupuncture in Guyana was suggested that targeting solutions of the diseases problems could help the overseas expansion of acupuncture to a higher level.