Importance: This systematic review summarizes existing studies on dry needling for spasticity and range of motion (ROM) and discusses its potential for use as an occupational therapy intervention. Objective: To examine existing studies on the effects of dry needling on spasticity and ROM. Data Sources: Article citations and abstracts from Scopus, Cochrane Library, PubMed, CINAHL, and a university library search. Study Selection and Data Collection: Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines were used in abstracting data. Peer-reviewed journal articles published in English between January 2007 and June 2019 were searched. Of 270 identified studies, 10 met the inclusion criteria. Studies were divided into categories on the basis of outcome measures (Modified Modified Ashworth Scale and ROM). Pain outcome measures were excluded because a systematic review addressing this outcome has recently been completed. Findings: Strong evidence was found to support the use of dry needling to decrease spasticity and increase ROM. Conclusions and Relevance: This systematic review suggests that dry needling is an effective physical agent modality to decrease spasticity and increase ROM, both of which are potentially beneficial to functional outcomes. What This Article Adds: This article provides information that may be helpful in determining the appropriateness of dry needling as an occupational therapy intervention.