Objective To assess the effectiveness and safety of various types of acupuncture in the treatment of mammary dysplasia. Methods We searched The Cochrane Library, CENTRAL, MEDLINE (1966 to 2004), EMBASE (1980 to 2004), CBM (1975 to 2004), CNKI (1997 to 2004) and reference lists, databases of ongoing trials and relevent academic conference proceedings. Results Five studies involving 534 women ranging from 78 to 180 met the inclusion criteria. The recovery rates of two groups in one study showed acupuncture was statistically superior to Rupixiao (RR 9.00, 95%CI 2.29 to 35.43; RR 8.04, 95%CI 2.20 to 32.02), six good improvement rates (including groups analysis) indicated that there was no significant difference between acupuncture and other therapies. None of the studies reported incidence of adverse reaction. Conclusions Overall, there is no conclusive evidence for acupuncture in the treatment of mammary dysplasia because the quality of included studies and amount of evidence are both poor and insufficient. There is an urgent need for larger, well-designed randomised controlled trials to assess the effectiveness and adverse-effect of acupuncture.