Chronic fatigue syndrome (CFS) affects more than 65 million patients worldwide and has a combined prevalence of 45.2% at 4 weeks in patients with novel coronavirus. Women, people over 40 and those with low incomes are among the most at-risk groups. The article reviews the epidemiology of CFS, including global trends, regional differences in incidence and prevalence, as well as risk factors such as heredity, infection, and childhood trauma. It describes the development of diagnostics, including clinical criteria, immune and metabolic biomarkers, MRI and genetic aspects such as genomic association or familial aggregation. The pathophysiology includes abnormalities of NK cells and immune factors, hypothalamic-pituitary-adrenal axis dysfunction, and disturbances of energy and lipid metabolism. The study focuses on acupuncture and moxibustion in the treatment of CFS, analyzes their historical application, relation to pathological mechanisms, theoretical basis of traditional Chinese medicine and modern mechanisms of action. It presents the results of clinical treatment, methods of evaluating effectiveness, individualized strategies, innovative techniques such as electroacupuncture or acupuncture catgut, as well as combinations with traditional Chinese medicine and psychotherapy. It discusses controversies over efficacy, safety and ethics, as well as future research directions and international collaboration.