The objective of this pilot study was to evaluate the cerebral effects of laser stimulation and traditional needle acupuncture in patients after stroke. Seventeen stroke patients (12 female and five male; mean age ± SD: 66.5 ± 12.9 years) were randomly selected in a stroke rehabilitation hospital. Patients' regional cerebral blood oxygen saturation (rSO2) values were recorded before, during, and after needle acupuncture (scalp, ear and body) as well as before, during, and after corresponding laser stimulation (red laser, four points: 100 mW, 658 nm, 500 µm; yellow laser, one point: 50 mW, 589 nm, 500 µm; infrared laser, three points: 100 mW, 810 nm, 500 µm; green laser, one point: 5 mW, 532 nm, 500 µm) in a cross-over study design. There were no significant changes after needle acupuncture in the phases immediately after needle insertion or during acupuncture stimulation. However, after manual needle acupuncture and after laser stimulation, the majority of the rSO2 values showed increases. The highest value (+3%) was reached after laser stimulation treatment. Heart rate and blood pressure before and after the treatments did not show significant alterations. Changes in local cerebral oxygen saturation could be quantified, although confirmation may only be expected after extensive follow-up studies.