Background Ankle osteoarthritis (AOA) is a prevalent condition that affects joint function, often leading to pain, inflammation, and impaired mobility, significantly impacting patients’ quality of life. Objective This study explores the effects of electroacupuncture treatment on clinical outcomes and gait characteristics in patients with ankle osteoarthritis (AOA). Methods A total of 78 patients with AOA were randomly divided into a experiment group and a control group. The control group was treated with strength training, and the experiment group was additionally treated with electroacupuncture. The Ankle Osteoarthritis Scale (AOS), American Foot and Ankle Society's Ankle and Hindfoot Scale (AOFAS-AHS), and the 3D Motion Analysis System were used before and after the intervention to assess the clinical outcomes and changes in kinematic parameters in the AOA patients before and after therapy. Results After treatment, the differences in intra-group comparisons and inter-group comparisons of AOS scores, AOFAS-AHS scores, stride length, stride length, single-support phase, and gait variable scores (GVS) of ankle dorsiflexion-plantarflexion of the patients in the experiment group were statistically significant; the differences in inter-group comparisons of GVS scores of hip rotation of the patients in the experiment group were statistically significant; and the differences in the gait profile scores (GPS) and gait deviation indices of the patients in the experiment group were statistically significant. The differences in the intra-group comparisons were statistically significant. The within-group comparisons of AOS score, AOFAS-AHS score, GPS score and GVS score of ankle dorsiflexion-plantarflexion were statistically significant in the control group patients. Conclusions Electroacupuncture has shown promise as an adjunctive therapy for patients with AOA, offering a more holistic rehabilitation strategy. By improving joint mobility and optimizing gait mechanics, electroacupuncture can effectively reduce pain, facilitate the restoration of normal gait patterns, and enhance patients’ overall quality of life.