This paper briefly reviewed the “three acupuncture waves” in the United States, and focused on the development of American acupuncture and moxibution in all aspects of the health, education, license and examination, legislation and insurance, research, communication and cooperation, so as to illuminate the current situation of Chinese acupuncture and moxibution in the United states. After 40 years of development, acupuncture and moxibution have become an indispensable therapy in the American complementary and alternative medicine, which has been widely recognized by the American people. Acupuncture and moxibution are more and more broadly used; the education system is getting better and better; the licensing examination tends to be standardized; the legal system is gradually perfected; the medical insurance has an equal coverage; scientific research projects continue to increase; the exchanges and cooperation between China and the United States are increasingly deepening. With high attention to the Chinese and American governments, in-depth development of acupuncture and moxibution in traditional Chinese medicine cultural exchanges, the acupuncture and moxibution in the United States are bound to become increasingly prosperous and strong.