Objective: To update the current evidence of the effect of acupuncture on recovery Heart Rate (HR), blood lactate and maximum volume of oxygen consumption (VO2max) following intense exercise through a systematic review of published randomised controlled trials.Methods: A systematic literature search was performed on electronic databases from inception to 2020. The Cochrane Handbook guidelines for Systematic Reviews of Interventions were used to assess the methodological quality and exclude studies with fatal flaws. The risk of bias was assessed using the Cochrane grading system by two reviewers (SB and BL). Acupuncture intervention was assessed using the Standards for Reporting Interventions in Clinical Trials of Acupuncture (STRICTA). This review is reported according to the PRISMA guidelines.Results: A total of 16 RCTs were included in this review. 8 of the 10 studies that assessed the effect of acupuncture on HR recovery found acupuncture to be significantly more effective than no treatment or sham acupuncture at enhancing recovery HR following exercise. 7 of the 10 studies that assessed the effect of acupuncture on reducing blood lactate found that acupuncture was significantly more effective than no treatment or sham acupuncture at reducing blood lactate following exercise. 4 of the 7 studies that assessed the effect of acupuncture on VO 2 max found that there was no significant difference between groups with regards to VO 2 max. Conclusion:Our results indicate that there is strong evidence that acupuncture is significantly more effective than sham and control in enhancing recovery HR and blood lactate following intense exercise. However, there is conflicting evidence with regards to the effect of acupuncture on enhancing VO 2 max in athletes. Future studies are required that follow the STRICTA guidelines to help determine the effect of acupuncture on enhancing VO 2 max in athletes.