Objective To assess the efficacy and safety of acupuncture for patients with hiccups after stroke. Methods The randomized controlled trials (RCTs) of acupuncture for patients with hiccups after stroke were collected by searching PubMed, The Cochrane Library, CNKI, VIP, and WangFang databases. The quality of the included studies was evaluated and the data were retrieved according to the methods recommended by the Cochrane Collaboration. Meta-analyses were conducted by using RevMan software. Results Three trials involving 143 patients were included. All of them were open-label controlled without observing the effective rate and mortality rate (or dependence rate) at the end of follow-up visit lasting for at least three months. The result of meta-analyses showed that the group of acupuncture plus drug was more effective for hiccup after stroke than the drug group at the end of the treatment, and the difference was significant (OR=9.05, 95%CI 3.17 to 25.82, Plt;0.000 01). The three studies did not report any adverse reactions. Conclusion Although the acupuncture has the short-term improvement trend without adverse events for hiccups after stroke, the confirmed conclusion of long-term effectiveness has not yet been reached because both the methodological quality and the quantity of all included studies are poor, and especially the long-term outcome measures are insufficient. There is no enough evidence to recommend acupuncture as a routine treatment for hiccups after stroke. So more high-quality multi-center RCTs in large scale are required.