Acupuncture treatment for oculomotor nerve palsy has been increasing recently. This study analyzed randomized controlled trials (RCTs) and case reports, using the Cochrane risk of bias tool to investigate the efficacy of acupuncture therapy for oculomotor nerve palsy. This analysis was performed on March 7, 2019, using online databases (PubMed, Cochrane, NDSL, OASIS, CNKI) where 208 articles were retrieved. Of these, there were 18 case reports and 18 RCTs that matched the inclusion criteria, of which 32 studies used acupuncture as the primary intervention, 1 used pharmacopuncture, 1 used fire-needling, and 1 used electroacupuncture. The most commonly used acupoints were BL1, BL2, ST2, TE23, Ex-HN5, LI4, GB14, ST36, GB20 and GB1. Significant findings were reported in all RCTs. Six adverse events were reported in 3 RCTs, with no effect on the outcome. No side effects were reported in the case reports. The risk-of-bias analysis showed that the articles did not report the experimental protocol used and it was not clear whether the study was blinded. Hence, it was difficult to assess the risk of bias. Analysis of 36 studies showed that acupuncture therapy for oculomotor nerve palsy was effective in many cases. It was difficult to evaluate the potential bias.