Acupuncture is a nonpharmacological treatment option for multiple different diseases and symptoms.  Although numerous studies have been done regarding the efficacy of acupuncture, there only been a few landmark high-quality randomized controlled trials.  The article mainly focuses on the evidence of these high-quality studies.  This in-office procedure has varying degrees of efficacy. Acupuncture treatments include nausea, pain, allergies, hot flashes, breathing difficulty, mood disorders, dyspepsia, and even tobacco use.  Acupuncture is mainly safe.  Local side effects can occur, but they typically resolve reasonably quickly after removing the acupuncture needle. Acupuncture is most commonly used in the treatment of chronic, noncancer pain in adults.  Acupuncture is a system of medical treatment and ideology based on the principle of applying small needles or pressure to specific points in the body.  The origins of this treatment system are grounded in traditional Chinese medicine (TCM), with underlying philosophical principles associated with Confucianism and Taoism. Under this ideology, health stems from the alignment of qi, which means “vital energy” and encompasses the yin/yang dichotomy that flows through all of the physical worlds. Five elements are the foundation of this theory of qi: wood, water, fire, earth, and metal. A blockage or excess of any disrupts this vital energy. Acupuncture aims to open the blockage or reduce the excess of qi flowing through specific channels in the body, known as meridians.  Under this ideology, health is not simply the absence of disease but rather the functioning interconnection of wellness. There are no isolated symptoms, but rather each symptom arises in the context of blockage or excess specific to the individual. Balancing the qi restores the interconnectedness, thus restoring wellness. Although acupuncture originated in TCM, its migration to the West was through other Asian countries, chiefly Korea and Japan. Many consider this a relatively recent movement; however, Osler himself mentioned acupuncture in his writings on medicine in the 1700s. However, acupuncture was considered for some time as a fringe treatment and not part of legitimate medical care. The efficacy of acupuncture is changing. Up to 1.5% of the US population has utilized acupuncture at some point, and the service is even available at many top academic medical centers in the United States. Acupuncture is seldom used as a sole treatment, however, but rather in conjunction or as an adjunct to traditional medical care. As more studies are done showing the efficacy of acupuncture to treat various types of pain, insurance companies are beginning to take notice. Acupuncture is now an in-office procedure covered by multiple insurance providers. Multiple studies have shown the effectiveness in the treatment of back pain, either acute or chronic, knee pain secondary to osteoarthritis, myofascial pain, and headaches . However, it must be noted that there is a significant placebo effect. There is power in belief. Many studies show not only acupuncture leading to superior pain relief for various ailments but also sham acupuncture. However, given the overall positive patient response, limited side effect profile, and little to no cost on the healthcare system, acupuncture is an essential alternative treatment modality .