A 5-year-old pregnant Huacaya alpaca presented for acute onset of severe weakness and inability to rise (Downer Syndrome). She was found acutely down in the pasture, laterally recumbent and unable to initiate movements. Diagnostic tests were performed but no definitive diagnosis was established. Her condition was stabilized using conventional emergency medical procedures. Once stabilized, 2 weeks after initial presentation, a Traditional Chinese Veterinary Medicine examination was performed. A Global Qi Deficiency pattern was diagnosed based on the presence of quadriparesis and lethargy. There was Heat in the Upper Burner (Shang Jiao) as evidenced by a red tongue and red oral mucous membranes. False Heat was suspected due to the severe Qi Deficiency causing Yin Deficiency. These deficiencies were most likely a result of her pregnancy, which may have exacerbated a previous underlying Kidney Qi and Yin Deficiency. Quadriparesis may be associated with Deficient Kidney/Spleen Qi causing weakness of the limbs. Seven acupuncture treatments (dry needles, electro-acupuncture, aqua-acupuncture) were administered for 3 months (weekly then every 2 weeks). Daily physical rehabilitation was also provided. By combining acupuncture and physical rehabilitation with conventional treatments and supportive care, the alpaca began walking on her own in approximately 50 days after onset and recovered within three months with a viable fetus. This case is an example of how a combination of acupuncture, physical rehabilitation and conventional treatments can be integrated for a successful recovery of acute quadriparesis of unknown origin (Downer Syndrome) in camelids and other species.