Background <p>Auriculotherapy has become a promising complementary therapy and is widely used to manage various symptoms and diseases. However, little is known about patients’ knowledge and attitudes. This study aimed to identify and synthesize the factors that influence acceptance and adherence related to auriculotherapy from patients’ perspectives.</p> Methods <p>The thematic synthesis developed by Thomas and Harden was applied to guide this review. Six common English databases (PubMed, Web of Science, Embase, Cochrane Library, CINAHL, and PsycINFO) and four common Chinese databases (CNKI, VIP, WangFang, and Sinomed) were searched in December 2023. The quality of the included studies was assessed using the Critical Appraisal Skills Programme. Data synthesis was conducted using the theoretical domains framework.</p> Results <p>Ten studies with eleven publications were included. Twenty-four barriers and fourteen facilitators on patients’ acceptance and adherence to auriculotherapy were identified under nine of the theoretical domains framework domains. Among these domains, “knowledge (<i>n</i> = 2)”, “memory, attention and decision processes (<i>n</i> = 2)”, and “environmental context and resources (<i>n</i> = 5)” reported only barriers. Besides, the most frequently mentioned domains in the included studies were “beliefs about consequences (<i>n</i> = 10)” and “emotions (<i>n</i> = 6)”.</p> Conclusions <p>Our findings provide a comprehensive overview of the factors affecting the patients’ behavior in receiving and complying with auriculotherapy, which may help healthcare professionals deeply understand the factors that influence patients’ intentions to use auriculotherapy and better interact with them. Further research that addresses these modifiable factors and develops relevant interventions may aid in meeting the growing use of auriculotherapy by patients.</p> Trial registration <p>This study was registered with PROSPERO in Dec 2023 (Registration number: CRD42023488856).</p>