In this study, the authors performed a systematic review aimed to evaluate the current evidence regarding the efficacy and safety of acupuncture on primary dysmenorrhea ⁽¹⁾. This study included randomized controlled trials (RCTs) of women with primary dysmenorrhea; these RCTs compared acupuncture to no treatment, placebo, or medications, and measured menstrual pain intensity and its associated symptoms. The review included 60 RCTs; the meta-analysis included 49 RCTs. Most studies showed a low or unclear risk of bias. They found that compared to no treatment, manual acupuncture and electro-acupuncture was more effective at reducing menstrual pain, and compared to nonsteroidal anti-inflammatory drugs, manual acupuncture, and warm acupuncture were more effective at reducing menstrual pain. Some studies showed that the efficacy of acupuncture was maintained after a short-term follow-up.