Objective To explore the effects of body constitution-based five-element music therapy combined with auricular copper-plate scraping in elderly patients with insomnia, and to offer an avenue for improving sleep quality of the elderly. Methods Eighty-six hospitalized elderly patients with insomnia were randomly divided into two groups, with 43 in each group.The control group received auricular copper-plate scraping based on their insomnia syndrome type, while the intervention group additionally received five-element music therapy.The intervention lasted for two weeks.The Pittsburgh Sleep Quality Index (PSQI), the Insomnia Severity Index (ISI), the Self-rating Anxiety Scale (SAS), and the Self-rating Depression Scale (SDS) were used to evaluate the cli-nical efficacy. Results After the intervention, the intervention group showed significantly lower scores on the PSQI, ISI, SAS, and SDS compared to the control group, and demonstrated significantly higher clinical efficacy (all P＜0.05). Conclusion Body constitution-based five-element music therapy combined with auricular copper-plate scraping can effectively improve sleep quality and ameliorate anxiety and depression in elderly patients with insomnia.