The meta-analysis included 23 randomized controlled trials with 2454 participants that assessed the efficacy and safety of acupuncture for functional dyspepsia. Compared with sham acupuncture, acupuncture improves FD symptoms by −14.46 points on the 195-point NDSI scale (95% CI −16.31 to −12.62) and quality of life by 10.39 points on the 100-point NDLQI scale (95% CI 7.06 to 13.73), without increasing adverse events (relative risk 1.15, 95% CI 0.63 to 2.09); the evidence is of high to moderate certainty according to GRADE. Compared to no treatment or usual care, it improves symptoms by −20.19 points on the NDSI (95% CI −30.22 to −10.15) with moderate certainty of evidence. Compared with prokinetics (itopride, mosapride, domperidone), it improves quality of life by 5.69 points on the 100-point NDLQI (95% CI 4.36 to 7.02) and may improve symptoms by −17.40 points on the 195-point NDSI (95% CI −29.08 to −5.72). Databases reviewed through March 13, 2025. Acupuncture likely improves FD symptoms and quality of life compared with sham acupuncture, no treatment, usual care, and prokinetics.[2]