Abstract. (Aims) Acupuncture was employed since 2 millenaries, but the underlying mechanisms are not globally handled. The present study is aimed at proposing an explanation by pointing out involved processes and a convincing modeling to demonstrate its efficiency when carried out by trained practitioners. (Method) In the absence of global knowledge of any mechanism explaining the acupuncture process, a biological model is first developed, based on stimulation in a given domain around the needle tip of a proper mastocyte population by a mechanical stress, electrical, electromagnetic, or heat field. Whatever the type of mechanical or physical stimuli, mastocytes degranulate. Released messengers either facilitate the transfer of main mediators, or target their cognate receptors of local nerve terminals or after being conveyed by blood their receptors on cerebral cells. Signaling to the brain is fast by nervous impulses and delayed by circulating messengers that nevertheless distribute preferentially in the brain region of interest due to hyperemia. The process is self-sustained due to mastocyte chemotaxis from the nearby dense microcirculatory circuit and surrounding mastocyte pools, which are inadequate for acupuncture, but serve as a signal relay. A simple mathematical model is solved analytically. Numerical simulations are also carried out using the finite element method with mesh adaptivity. (Results) The analytical solution of the simple mathematical model demonstrates the conditions filled by a mastocyte population to operate efficiently. A theorem gives the blow-up condition. This analytical solution serves for validation of numerical experiments. Numerical simulations show that when the needle is positioned in the periphery of the acupoint or outside it, the response is too weak. This explains why a long training is necessary as the needle implantation requires a precision with a magnitude of the order of 1 mm. (Conclusion) The acupoint must contain a highly concentrated population of mastocytes (e.g., very-high-amplitude, small-width Gaussian distribution) to get an initial proper response. Permanent signaling is provided by chemotaxis and continuous recruitment of mastocytes. Therefore, the density and distribution of mastocytes are crucial factors for efficient acupuncture as well as availability of circulating and neighboring pools of mastocytes. AMS subject classifications: 76M10, 92C10, 92C17, 92C50