Objective: To observe the effect of intradermal needle therapy on back-shu points of five zang organs in treating chronic fatigue syndrome (CFS) and provide evidence for the usage of unilateral back-shu point. Methods: Patients were randomly divided into bilateral back-shu point group, unilateral back-shu point group and non-acupoint group, remove shedding cases, each group remaining 30 patients. In bilateral back-shu point group, both sides of back-shu points of five zang organs were selected. In unilateral back-shu point group, only one side was selected, left or right alternately. The location where non-acupoint group inserted by intradermal needles were outward from the back-shu points, left or right alternately. Fatigue Scale-14 (FS-14) was used to evaluate the fatigue level and the scores\' improvement of physical fatigue and mental fatigue revealed the therapeutic effect on body constituents and spirits of CFS patient. Results: After the 8-week intradermal needle therapy, the total effective rate was 83.33％ in the bilateral back-shu point group, which was 76.67％ in the unilateral back-shu point group and 50.00％ in the non-acupoint group. The curative effects of the two groups whose back-shu points of five zang organs were inserted by intradermal needles were better than the non-acupoint group(P0.05). There were statistical differences in FS-14 questionnaires including total, physical and mental scores between before and after the treatment in both the two back-shu point groups(P<0.05). Only the scores of total and physical fatigue in decreased in non-acupoint group(P0.05). Conclusions: (1) The intradermal needle therapy on back-shu points of five zang organs for CFS has a satisfying clinical efficacy in curing tiredness. It can help to reduce both physical and mental fatigue for the patients. Hence, it can regulate both body constituents and spirits simultaneously. (2) Needling the unilateral acupoints can get similar clinical efficacy to the bilateral points. It reveals that we can cut cost by reducing the consumption of the amount of intradermal needles used on one side. (3) Both the groups of back-shu points get better clinical efficacy than the non-acupoint group dramatically. The reason of why the intradermal needle can treat CFS maybe that back-shu points of five zang organs can regulate the functions of five zang organs characteristically.