Acupuncture, as a cornerstone therapeutic modality within traditional Chinese medicine, has long attracted scholarly attention regarding the scientific elucidation of its mechanisms of action. With continuous advancements in research technologies within the field of brain science, a theoretical framework of acupuncture neuroscience has progressively taken shape and evolved, bridging the gap between empirical medical practices in traditional acupuncture and evidence-based research in modern neuroscience. Current studies, employing advanced methodologies such as functional magnetic resonance imaging (fMRI), electroencephalography (EEG), and neuromodulation techniques, have gradually uncovered its neurobiological mechanisms. These investigations demonstrate that acupuncture can modulate cerebral functional activity and promote neural network reorganization and activation, thereby providing a physiological basis for its therapeutic effects. In light of the challenges facing the development of acupuncture neuroscience—including the high complexity of its mechanisms, multi-target integrative characteristics, as well as the need for standardized research paradigms and evaluation criteria—this analysis aims to systematically synthesize multidisciplinary evidence, clarify key scientific questions, and propose research pathways to advance the field toward more standardized and precise approaches.