Background: Many women need some kind of pain relief during labor. The aim of this study was to investigate whether acupuncture has an effect on pain management in labor. Methods: I searched the Cochrane Central Register of Controlled Trials (September 2009) and PubMed (September 2009). Only published randomised controlled trials comparing acupuncture with; sham-acupuncture, transcutaneous electrical nerve stimulation (TENS), sterile water injections, pethidine, none or other traditional analgesics, were included.Results: Four trials were included in this literary study with data reporting on 1235 women. The results suggest a significant efficacy of acupuncture compared to sham-acupuncture on labor pain. Acupuncture may reduce the need for pharmacological pain relief in labor. There is no statistical significant efficacy in the experience of total pain between patients receiving transcutaneous electrical nerve stimulation, acupuncture or traditional analgesia. Women receiving sterile water injections experienced greater pain relief and relaxation than the women receiving acupuncture. Maternal satisfaction with acupuncture was as high as 86% in one trial and many women said they would want acupuncture during another labor. Conclusion: Acupuncture may be beneficial for the management of pain during labor. The results indicate lower use of pharmacological analgesia. However, further randomised trials assessing direct pain relief are required.