Melasma is a pigmented and disfiguring skin disease occurring on the face, typically manifested as symmetrical yellowish-brown patches, commonly seen in young and middle-aged women. Its pathogenesis is related to multiple factors such as endocrine disorders and ultraviolet radiation, characterized by difffculty in cure and high recurrence rate. Meanwhile, it impairs patients' physical and mental health and reduces their quality of life. As a classic external therapy of traditional Chinese medicine, acupuncture has been widely used in the treatment of melasma and continuously developed due to its safety, effectiveness and few side effects. Based on relevant clinical studies in recent years, this paper reviews the research progress of acupuncture therapy in the treatment of melasma from the aspects of traditional Chinese medicine understanding of melasma, advantages and speciffc methods of acupuncture treatment, so as to provide evidence and practical guidance for clinical treatment.