To compare the effectiveness of dry needling versus myofascial release on myofascial trigger points pain in cervical muscles, quality of life, impact of symptoms pain, quality of sleep, anxiety, depression, and fatigue in patients with fibromyalgia syndrome. A single-blind randomized controlled trial was conducted. Sixty-four subjects with fibromyalgia were randomly assigned to a dry needling group or a myofascial release group. Pain pressure thresholds of myofascial trigger points were evaluated in the cervical muscles. In addition, quality of life, impact of fibromyalgia symptoms, quality of sleep, intensity of pain, anxiety and depression symptoms, impact of fatigue at baseline and post treatment after four weeks of intervention were evaluated. Significant improvement was found in most pain pressure thresholds of the myofascial trigger points in cervical muscles in the dry needling group compared to myofascial release ( < 0.05). Similarly, these differences between groups were found for the components of quality of life of physical function ( = 12.74,  = 0.001), physical role ( = 11.24,  = 0.001), body pain ( =30.26,  < 0.001), general health ( = 15.83,  < 0.001), vitality ( = 13.51,  = 0.001), social function ( = 4.73,  = 0.034), emotional role ( = 8.01,  = 0.006), and mental health ( = 4.95,  = 0.030). Similar results were achieved for total impact of FMS symptoms ( = 42.91,  < 0.001), quality of sleep ( = 11.96,  = 0.001), state anxiety ( = 7.40,  = 0.009), and trait anxiety ( = -14.63,  < 0.001), hospital anxiety and depression ( = 20.60,  < 0.001), general pain intensity ( = 29.59,  < 0.001), and fatigue ( = -25.73,  < 0.001). The dry needling therapy showed higher improvements in comparison with myofascial release therapy for pain pressure thresholds, the components of quality of life of physical role, body pain, vitality and social function, as well as the total impact of FMS symptoms, quality of sleep, state and trait anxiety, hospital anxiety-depression, general pain intensity and fatigue. Implications for rehabilitation Dry needling therapy reduces myofascial trigger point pain in the short term in patients with fibromyalgia syndrome. This therapeutic approach improves anxiety, depression, fatigue symptoms, quality of life, and sleep after treatment. Dry needling and myofascial release therapies decrease intensity of pain, and the impact of fibromyalgia symptoms in this population. These intervention approaches should be considered in an independent manner as complementary therapies within a multidisciplinary setting.