The acupuncture procedures in Hwangjenaekyung (黃帝內經) was different to modern ones in many aspects. Especially, the role of pulse diagnosis in acupuncture was totally different and the pulse diagnosis was essential part in acupuncture therapy in Hwangjenaekyung era. We found four noteworthy features on the pulse diagnosis before and after acupuncture in Hwangjenaekyung : (1) Pulse diagnosis was a mandatory process in acupuncture (2) Doctors who used pulse diagnosis in 12 meridians (十二經脈遍診脈法), pulse diagnosis in 9 points of 3 body parts (三部九候脈法), and comparative pulse diagnosis between radial artery and carotid artery (人迎寸口對比脈法) followed the former rule ((1)). (3) The major pulse features to detect before and after acupuncture were conversion between the vacuous pulse (虛脈) and the replete pulse (實脈), and conversion between slippery pulse (滑脈) and rough pulse (澁脈). (4) Deukki (得氣, Deqi) was synonym of Kiji (氣至), and it referred to the changes of arterial pulse, not the sensation followed by acupuncture manipulation.