Perimenopausal insomnia often shows the lack of quality or quantity of sleep, such as hard to sleep, wake up earlier, easier to wake up, and often accompanied by irritability, dizziness, palpitation, the symptom such as sweat out, hot flashes, night sweats, or mood problems such as depression, anxiety. The incidence of it increased year by year, the symptoms affects the work and daily life of modern women severely. Modern medicine believes the decline in estrogen levels is the cause, so hormone replacement therapy (HRT) is often used in clinic. But its side effects and drug dependence are much criticized. Traditional Chinese Medicine (TCM) believes that the deficiency of kidney is the root cause, leading to the imbalance of Yin and Yang. Acupuncture, as an effective therapy without side effects and obvious dependence, is now attracting more and more attention. This review mainly sums up by the selecting of acupoints, the location and the depth of the acupuncture therapy and other therapies recorded in published reports of treating insomnia in perimenopause, hoping it will be helpful to clinical treatment.