This systematic review examined the effects of acupuncture on relieving adenomyosis symptoms. Eleven randomized controlled trials involving 942 women were included. Acupuncture was found to significantly reduce uterine size and CA125 levels compared to pharmacological medicine alone. It also improved dysmenorrheal symptoms after three months of treatment. Additionally, the incidence of adverse events, especially hot flashes, was lower in the acupuncture group. The study suggests that acupuncture holds promise as an alternative treatment for adenomyosis, but further rigorous trials are required to confirm these findings.