Over the past decade, acupuncture clinical research has accumulated substantial high-quality evidence in the prevention and treatment of diseases across multiple disciplines. Its indication scope has been continuously expanded, research designs have become increasingly standardized, control protocols for sham/placebo acupuncture have been gradually optimized and standardized, and attention to real-world research (RWR) has kept rising, with a preliminary multi-dimensional efficacy evaluation system established. The standardization of clinical trial reporting has been steadily improved, and neuroimaging technologies—such as functional magnetic resonance imaging—have emerged as crucial tools to elucidate the correlation between acupuncture's clinical effects and central nervous system mechanisms. Future research should build on the unique characteristics and advantages of acupuncture, focusing on three core areas: diseases amenable to independent acupuncture intervention, major chronic diseases where acupuncture serves as an adjuvant therapy, and research related to traditional Chinese medicine "preventive treatment of disease". It is imperative to further optimize the control design of randomized controlled trials, enhance the data quality of RWR, refine core disease outcome indicators, and strengthen whole-process quality control in research. Meanwhile, combined with the holistic and multi-target characteristics of acupuncture, neuroimaging and other advanced technologies should be employed to conduct multi-dimensional and dynamic efficacy evaluations, thereby driving the high-quality development of acupuncture clinical practice with solid scientific evidence.