Objective To explore the awakening efficacy of transcranial direct current stimulation （tDCS） combined with median nerve electrical stimulation（ MNS） in patients with prolonged disorders of consciousness（ pDOC）. Methods From January to September 2024， 45 patients with pDOC after brain injury in the Intensive Rehabilitation Unit of the Department of Neurological Rehabilitation， Xuzhou Rehabilitation Hospital， Xuzhou Medical University， were selected for the study. The patients were divided into control group， tDCS group and combined group according to the randomized numerical table method， with 15 cases in each group. Patients in control group received conventional rehabilitation therapy， patients in tDCS group were given conventional rehabilitation therapy and tDCS， and patients in combined group were treated with conventional rehabilitation therapy， tDCS and MNS for four weeks. The Revised Coma Recovery Scale（ CRS-R）， Glasgow Coma Scale（ GCS）， Full Outline Unresponsiveness Scale（ FOUR）， and quantitative electroencephalograms ｛including the power ratio index［ α（/ δ+θ）］ and α-wave relative power（ αRP）｝ were used to compare the level of consciousness and the brain electrophysiologic function of the patients with pDOC before and after four weeks of treatment， respectively. Results There was no statistically significant difference in CRS-R， GCS， FOUR scores， α（/ δ+θ）， and αRP among the three groups of patients before treatment（ P＞ 0.05）. The CRS-R score［ （14.73±3.11） in combined group，（ 11.53±3.14） in tDCS group，（ 9.07±2.09） in control group］， GCS score［ 12（ 11，13） in combined group， 10（9，12） in tDCS group， 9（9，10） in control group］， and FOUR score［ 15（14，15） in combined group， 13（10，14） in tDCS group， 10（10，12） in control group］， and α/（δ+θ）［0.18（0.16，0.24） in combined group， 0.13（0.11，0.15） in tDCS group， 0.08（0.06，0.12） in control group］ were higher than the pre-treatment CRS-R score［ （8.33±1.87） in combined group，（ 7.53±0.50） in tDCS group，（ 7.93±1.75） in control group］， GCS score［ 9（9，9） in combined group， 8（7，9） in tDCS group， 9（8，9） in control group］， FOUR score［ 9（9，12） in combined group， 9（8，9） in tDCS group， 9（9，11） in control group］ and α（/ δ+θ）［ 0.09（0.06，0.12）in combined group， 0.08（0.05，0.12） in tDCS group， 0.09（0.05， 0.11） in control group］， the differences were statistically significant（ all P＜0.05）. The differences in CRS-R， GCS， FOUR score differences and α/（δ+θ），αRP differences before and after treatment were statistically significant in all three groups（ all P＜0.05）. The CRS-R score difference（ 6.40±2.77）， α（/ δ+θ） difference 0.10（ 0.06，0.14）， and αRP difference 0.08（ 0.06，0.11） before and after treatment in patients in combined group was higher than those in tDCS group［ CRS-R score difference（ 4.00±2.17）， α（/ δ+θ） difference 0.05 （0.03，0.06）， αRP difference 0.04（0.03，0.06）］ and control group［ CRS-R score difference（ 1.10±0.88） points， α（/ δ+θ） difference 0.01（0.00，0.02）， αRP difference 0.01（ 0.00，0.02）］， the differences were statistically significant（ all P＜0.05）. The difference in GCS score of 3（2，4） and the difference in FOUR score of 4（4，6） before and after the treatment of patients in combined group were higher than those of control group［ difference in GCS score of 1（1，1） and difference in FOUR score of 1（1，1）］， and the differences were statistically significant（ all P＜0.05）. Conclusions MNS combined with tDCS can effectively promote the improvement of the degree of consciousness and improve the awakening efficacy in pDOC patients.