Objective To observe the effect of catgut implantation at acupoint（CIAA）on the learning and memory function, hippocampal microangiogenesis, and the mRNA and protein expression of angiopoietin-1 (Ang-1)/vascular endothelial growth factor (VEGF) and its receptor TEK tyrosine kinase(TIE2)/VEGF receptor 2(VEGFR2) in rats with vascular dementia (VD). To explore the mechanism of catgut implantation at acupoint in preventing and treating VD.   Methods Using a random number table, VD rats were divided into a model group, a nimodipine group, and an catgut implantation at acupoint group, and a sham operation group was set up, with 10 rats in each group. On the 7th day after surgery, the treatment groups were given catgut implantation at acupoint and nimodipine gastric lavage for 21 days. After treatment, Morris water maze behavioral test was performed. HE staining was used to observe hippocampal CA1 tissue. CD34 immunohistochemical staining was used to detect hippocampal microvascular density (MVD). Real-time PCR and Western blotting were used to detect the mRNA and protein expression of Ang-1/VEGF and its receptor TIE2/VEGFR2 in the hippocampus.   Results Compared with the model group, the average escape latency of the other groups was significantly shortened, and the target quadrant residence time was significantly prolonged (P<0.01, P<0.05). Compared with the model group, the number of nucleolus and well-formed pyramidal cells in hippocampal CA1 area of the catgut implantation at acupoint group and the nimodipine group increased in varying degrees, and they were arranged more closely, with only a few cells scattered and swollen. In the sham surgery group, a few CD34 positive cells were scattered. The treatment groups had more closely distributed CD34 positive cells with significant staining compared to the model group. The MVD of the model group was significantly higher than that of the sham surgery group (P<0.01). Both nimodipine group and catgut implantation at acupoint group had higher MVD than the model group (P<0.05, P<0.01). Compared with the sham surgery group, the mRNA and protein expression of Ang-1/VEGF and its receptor TIE2/VEGFR2 in the model group increased significantly (P<0.01, P<0.05).   Compared with the model group, both nimodipine group and catgut implantation at acupoint group had higher mRNA and protein expression of Ang-1/VEGF and its receptor TIE2/VEGFR2 (P<0.01, P<0.05). Conclusion  Catgut implantation at acupoint can improve the learning and memory abilities in VD rats, promote hippocampal microvascular angiogenesis, which may be related to the up-regulation of Ang-1/VEGF and its receptor TIE2/VEGFR2 mRNA and protein expression.