Background: The use of acupuncture for common pediatric conditions continues to grow. Three previous overviews have summarized the research literature. Objective: The aim of this article is to provide an updated narrative review of the literature on the use of acupuncture within the pediatric population. Methods: A systematic search was performed to identify clinical trials and reviews published through July 2015. Trials were excluded if they were not: (1) acupuncture-specific; (2) limited to pediatric patients; (3) published in English. The literature was assessed and synthesized into a narrative review and commentary. Results: Seventy-one publications were identified (59 clinical trials and 12 reviews) that represented 20 conditions. Since the prior overviews, 36 new publications (33 clinical trials) were identified and represented nine countries; the top three were China, Norway, and the United States. The top five areas of research at that timepoint were autism spectrum disorder, cerebral palsy, colic, pain, and nausea and vomiting. Conclusions: Clinical trials in pediatric acupuncture (n = 59) represent a small subset of acupuncture research. Data are promising for conditions such as pain and amblyopia; however, conclusions cannot be made due to limited number of trials and heterogeneity of treatment approaches. Specifically, caution is warranted, as acupuncture needling of a single acupoint in clinical research may not be equivalent to acupuncture treatment in clinical practice. Further research on the use of acupuncture for pediatric conditions is warranted. The current authors posit that the early phase research model, with pragmatic treatment approaches, should be employed to all areas of study. The conditions with promising evidence may represent key areas of focus for future research.