OBJECTIVE: To assess the therapeutic effect and potential adverse effect of acupuncture in treatment of dysphagia after stroke. METHODS: A systematic review including all the relevant randomized controlled trials (RCTs) or quasi-RCTs of acupuncture and moxibustion for treatment of dysphagia after stroke were performed using the method recommended by the cochrane collaboration. RESULTS: Seven papers including 506 cases met the enrolled criteria. All of the trials were of lower methodological quality. Meta-analysis of enrolled 6 trials showed that the acupuncture group had a better therapeutic effect on dysphagia after stroke than the control group (RR 1.17, 95% CI 1.08, 1.27, Z=3.78, P=0.0002). The mortality and the occurrence of pneumonia were similar between acupuncture and control groups (RR 0.25, 95% CI 0.03, 2.18 and RR 3.02, 95% CI 0.093, 23.10, respectively). The treatment group significantly reduced in time of the thick barium through pharynx examined by videofluorography (WMD -7.23, 95% CI -13.18,-1.28). CONCLUSION: A reliable conclusion can not be drawn from the present data because of the defects in methodological quality, especially no long-term terminal outcome events, although it appears a tendency that acupuncture can improve dysphagia after stroke in short-term with no adverse effect. Therefore, it is necessary to perform more multi central randomized controlled trials in good internal validity and high quality in future.