A team of American authors has updated the evidence base for acupuncture as a treatment for acute pain, with analysis of systematic reviews and meta-analyses on post-surgical pain and acute non-surgical pain, including acute pain in the emergency department (ED). To update their previous 2018 white paper, they include 22 new systematic reviews, 17 with meta-analyses of acupuncture in acute pain settings. The majority of reviews found acupuncture therapy to be an efficacious strategy for acute pain, with potential to avoid or reduce opioid reliance. Evidence supported the feasibility and benefit of acupuncture as an effective standalone or adjunct intervention in acute perioperative pain, and acute pain in the ED or urgent care settings. The authors conclude that the evidence supporting effectiveness, safety, reduced need for opioids and NSAIDs, and improved patient satisfaction is a compelling reason for acupuncture to be covered as a treatment for acute pain by public and private insurance.