Background <p>Postoperative gastrointestinal dysfunction (POGD) is a common complication following gastrointestinal tumor surgery, significantly impairing patient recovery and quality of life. The efficacy of acupuncture in improving POGD remains unclear.</p> Objective <p>To evaluate the role of acupuncture in enhancing postoperative gastrointestinal function in patients with gastrointestinal tumors, providing evidence-based clinical insights.</p> Methods <p>Relevant studies were searched in PubMed, Cochrane Library, EMbase, Web of Science, China National Knowledge Infrastructure, Wanfang Data, and VIP Database from inception to December 4, 2024. Only clinical-type studies involving acupuncture or electroacupuncture in the treatment of patients with gastrointestinal tumors were included. The primary outcomes were the first flatus time, first bowel movement time, first oral feeding, and hospitalization time. Secondary outcomes included white blood cell (WBC) count and C-reactive protein (CRP) level. Study quality was appraised using the domain-based evaluation described in the Cochrane Handbook.</p> Results <p>This study included 8 randomized control trials (CRCTs) involving 413 patients. Meta-analysis revealed that acupuncture significantly reduced the time to first flatus (<i>P</i>&lt;0.05), time to first oral feeding (<i>P</i>&lt;0.05), and hospital stay (<i>P</i>&lt;0.05). However, it did not significantly affect the time to first bowel movement (<i>P</i>=0.53). Additionally, acupuncture significantly decreased CRP levels at 3 and 6/7 d postoperatively (<i>P</i>&lt;0.05), as well as WBC counts at 6/7 d (<i>P</i>&lt;0.05). The overall risk of bias of the included studies was rated as low to unclear.</p> Conclusions <p>Current evidence supports acupuncture as an effective adjunctive treatment for improving postoperative POGD in patients with gastrointestinal tumors. Further, high-quality RCTs are needed to validate these findings and optimize clinical protocols. (Registration No. CRD420250651195)</p>