OBJECTIVES: This study aimed to evaluate the effectiveness and feasibility of electroacupuncture (EA) in improving gastrointestinal peristalsis after laparoscopic surgery. METHODS: This was a single-center, two-arm, prospective randomized trial in which patients were randomly allocated in a 1:1 ratio into two groups after surgery at the Affiliated Traditional Chinese Medicine Hospital, Southwest Medical University, China. Members of both groups consented to standard postoperative treatment, and the intervention group received EA treatment starting 3-5 hours after surgery, as well as in the morning and afternoon on the first postoperative day. Defecation and flatus times were the co-primary outcomes. RESULTS: Among 88 patients who completed the outcome measurements, 43 patients were allocated to the intervention group and 45 to the control group. The mean (SD) time to first flatus was 36.4 (8.0) hours and 42.2 (8.5) hours in the intervention and control groups, respectively (HR 1.9, 95% CI, 1.2-2.9; P < 0.001). The mean (SD) time to first defecation was 46.0 (8.0) hours and 51.3 (9.4) hours in the intervention and control groups, respectively (HR 1.9, 95% CI, 1.2-3.0; P = 0.01). The Visual Analogue Scale (VAS) pain scores and Intake, Feeling nauseated, Emesis, Examination, and Duration of symptoms (I-FEED) scores were significantly lower in the intervention group compared to the control group (P < 0.001). CONCLUSION: EA demonstrates promising effects in accelerating the recovery of GI function and has potential for widespread adoption across diverse healthcare systems globally. However, its exact mechanism requires further in-depth research.