Objective: The aim of this study was to evaluate the effect of acupuncture (AP) in the treatment of primary dysmenorrhea (PD). Methods: A clinical prospective, placebo-controlled trial included 57 women with PD. Of these, 30 were treated with manual AP points: Du 20 (Baihui), bilateral Li 4 (Hegu), Ren 3 (Zhongji), Ren 4 (Guanyuan), Ren 6 (Qihai), bilateral Gb 34 (Yanglingquan), bilateral Ub 23 (Shenshu), bilateral Lp 6 (Sanyinjao) and auriculoacupuncture points (Shenmen); 27 women were treated with placebo AP. AP treatments were considered successful if PD did not occur any more, medication of PD became unnecessary or PD symptoms did not occur for 2 years after the AP treatment. Results: The occurrence of PD in nulliparae was statistically relevant (p < 0.001). Statistically relevant was also the decrease in medication in women to whom AP had been applied (p < 0.0001), which was not the case in the placebo group (p > 0.5). Conclusions: The success rate of AP for the treatment of PD symptoms within 1 year after the AP treatment is 93.3% in the first group and 3.7% in the placebo group.