A systematic review and meta-analysis evaluated the effectiveness of transcutaneous electrical stimulation of acupuncture points (TEAS) for the prevention of postoperative delirium (POD) in patients older than 60 years undergoing surgical procedures. They included 20 randomized controlled trials with 2290 patients comparing TEAS with sham or no stimulation. The incidence of POD was 5.6% in the TEAS group versus 17.0% in the control group (hazard ratio RR 0.34, 95% CI 0.26–0.45). TEAS significantly reduced the CAM score (MD −1.01, 95% CI −1.98 to −0.04), propofol consumption (MD −35.59 mg, 95% CI −65.75 to −5.42), and postoperative pain score (MD −0.60, 95% CI −1.42 to −0.00, something - text incomplete, but for context). It also improved the quality of recovery (QoR-15 score: MD 23.76, 95% CI 21.72–25.80). The procedure was safe with no reported serious side effects. Perioperative TEAS reduces the risk of POD in elderly patients.