ObjectiveTo evaluate whether and to what extent the new risk of bias (ROB) tool has been used in Cochrane systematic reviews (CSRs) on acupuncture. MethodsWe searched the Cochrane Database of Systematic Review (CDSR) in issue 12, 2011. Two reviewers independently selected CSRs which primarily focused on acupuncture and moxibustion. Then the data involving in essential information, the information about ROB (sequence generation, allocation concealment, blindness, incomplete outcome data, selective reporting and other potential sources of bias) and GRADE were extracted and statistically analyzed. ResultsIn total, 41CSRs were identified, of which 19 CSRs were updated reviews. Thirty-three were published between 2009 and 2011. 60.98% reviews used the Cochrane Handbook as their ROB assessment tool. Most CSRs gave information about sequence generation, allocation concealment, blindness, and incomplete outcome data, however, half of them (54.55%, 8/69) showed selective reporting or other potential sources of bias. Conclusion"Risk of bias" tools have been used in most CSRs on acupuncture since 2009. However, the lack of evaluation items still remains.