To evaluate the clinical efficacy and safety of acupuncture and moxibustion by analyzing Cochrane system review. Methods:Based on the data from the fifth “The Cochrane Library” in 2018, the keywords “acupuncture or acupoint or acupressure or electroacupuncture or moxibustion” were adopted to search the relevant full articles of systems review regarding acupuncture, such as manual acupuncture, electroacupuncture, acupressure, transcutaneous electrical stimulation and moxibustion. Results:Finally, 81 acupuncture Cochrane systematic reviews were included and the publications of those showed an upward trend, especially increased rapidly after 2009. The amount of publication in top five country was China (23, 28.4%), Britain (17, 21%), Australia (15, 18.5%), Canada (6, 7.4%), and the United States (4, 4.9%), involving 30 Cochrane collaborate groups, in which the core field of research were neurological diseases (21), genitourinary system diseases (10), pregnancy delivery and puerperal diseases (11), musculoskeletal system and connective tissue diseases (9), mental and behavioral disorders (5). Among included studies, 21 of them (25.9%) believed that acupuncture showed treatment effects, and 5 of them (6.2%) did not acknowledge the therapeutic effect of acupuncture, 55 of them (67.9%) did not provide sufficient evidence to prove the clinical efficacy of acupuncture. Conclusion:Acupuncture is widely used in various diseases, which broadens the spectrum of acupuncture and moxibustion. In addition, further analysis indicated that acupuncture shows especially positive treatment for pain diseases. However, most of CRS indicated low level of research evidence due to the methodological flaws of RCT study design and poor reporting quality.