Objective To explore the main factors influencing the therapeutic effect of acupuncture on neck pain caused by cervical spondylosis, so as to provide references for further increasing the therapeutic effect of acupuncture. Methods One hundred and six cases were randomly divided into an observation group and a control group, 53 cases in each group. The observation group was treated with routine acupuncture at Dàzhuī (大椎 GV 14), Jìngbǎiláo (颈百劳 EX-HN 15) and Jiānzhōngshū (肩中俞 SI 15); and the control group was treated with sham acupuncture at 1 cm lateral to Jìngbǎiláo (颈百劳 EX-HN 15) and Jiānzhōngshū (肩中俞 SI 15). The needles were retained for 20 min in the two groups and infrared radiation was used for adjuvant treatment in this period. Northwick Park Neck Pain Questionnaire (NPQ) was used to assess the patients' quality of life before and after the treatment and compare the therapeutic effect between two groups. The potential influential factors were analyzed by Logistic regression. Results The effective rate was 75.5% in the observation group and 52.8% in the control group with a significant difference between the two groups (P＜0.05). The Logistic regression analysis indicated that the therapeutic effect in the observation group was superior to that of the control group (OR=2.670), and both the attack frequency and duration of the neck pain would influence the therapeutic effect (OR=1.055 and OR=2.446). Couclusion Acupuncture has a preferable therapeutic effect on neck pain caused by cervical spondylosis, and patient's clinical history about attack frequency and duration of neck pain are factors influencing clinical therapeutic effect.