The invention belongs to the technical field of biology, and discloses an acupuncture serum exosome and a preparation method and application thereof. The preparation method comprises the steps that S1, a rheumatoid arthritis model is established, specifically, a complete Freund adjuvant is injected to the sole of the right posterior foot of a rat to cause inflammation, after 24 hours, interventional electro-acupuncture treatment is conducted on the rat, the sole pain threshold of the rat is measured by using a full-automatic thermal radiation stimulator, and whether the rheumatoid arthritis model is successfully molded or not according to a pain threshold measurement result is judged; S2, serum extraction is conducted, specifically, abdominal aorta blood sample collection is conducted on the successfully molded rat, the blood sample is allowed to stand for 2 hours, centrifuging is conducted for 10 minutes in a centrifugal machine with the temperature of 4 DEG C and the speed of 2000rpm, after centrifugation, supernate is taken as serum and subpackaged in EP tubes, 500 microliters of serum is subpackaged in each EP tube, and all the EP tubes are put into a refrigerator at the temperature of -80 DEG C to be cryopreserved for use; and S3, exosome extraction is conducted, specifically, exosome is extracted from the serum extracted in the step S2 to obtain the acupuncture-like serum exosome capable of being used for treating rheumatoid arthritis.