Objective To assess the efficacy of manual acupuncture (MA) in the treatment of myofascial pain syndrome (MPS).Methods We searched for randomised controlled trials (RCTs) on the comparison between MA and sham/ placebo/no intervention for MPS,from inception to January 2016,in the following databases: PubMed,The Cochrane Library,Embase,Web of Science,China Biology Medicine.Two reviewers independently screened the literature and extracted data,and assessed the quality of the included studies according to the risk of bias tool recommended by the Cochrane Handbook version 5.1.0.Then,a meta-analysis was performed using RevMan 5.3 software.Results Ten RCTs were combined in a sham-controlled meta-analysis.This meta-analysis showed a significant difference in the reduction of pain intensity,favoring MA after the stimulation of trigger points (SMD-0.90,95% CI-1.48 to-0.32;p=0.002),with a treatment period of 1 or 8 sessions (1 session: SMD-1.05,95% CI-1.84 to-0.27;p=0.009/8 sessions: WMD-1.96,95% CI-2.72 to-1.20;p < 0.00001).Regarding the increase in pressure pain threshold,the meta-analysis showed a significant improvement with MA after stimulation of the trigger points (WMD 1.00,95% CI 0.32 to 1.67;p =0.004) Two of the included studies reported mild adverse events (soreness,hemorrhage) during the MA process.Conclusions Through the stimulation of trigger points,MA might be efficient for pain relief and for the reduction of muscle irritability in patients with MPS.Additional well-designed and detailed-reported studies are required to regard the optimal number of sessions for the treatment of MPS.