Introduction: Acupuncture point injection therapy has been used for respiratory conditions, including chronic obstructive pulmonary disease (COPD), and may be an effective adjunct to pharmacotherapy. This review evaluated the efficacy and safety of acupuncture point injection therapy plus pharmacotherapy for COPD. Methods: Five English and four Chinese databases were searched from inceptions to May 2015. Studies of acupuncture point injection therapy reporting on clinical outcomes (including lung function, symptom severity, quality of life and exercise capacity) were included. Methodological quality was assessed using the Cochrane Collaboration's risk of bias tool, and data analysed using RevMan 5.2. Results: Twelve studies (841 participants) were included. Results from meta-analyses showed the combination of acupuncture point injection therapy plus pharmacotherapy produced better outcomes for lung function during acute exacerbation (FEV1 L: MD 0.16 L [0.04, 0.28], I-2 = 0%; FVC L: MD 0.29 L [0.14, 0.44], I-2 = 0%) and effective rate for stable COPD and acute exacerbations (RR 1.45 [1.17,1.79], I-2 = 0% and RR 1.16 [1.07, 1.26], I-2 = 0%, respectively) than pharmacotherapy alone. Higher arterial oxygenation (PaO2) was seen in participants with acute exacerbations who received acupuncture point injection therapy plus pharmacotherapy (MD 7.43 mmHg [3.49, 11.39], I-2 = 93%), although considerable statistical heterogeneity was detected. Conclusions: Based on the included studies, there is insufficient information on the safety of acupuncture point injection therapy for COPD. There is some evidence that acupuncture point injection therapy may improve lung function and effective rate in people with COPD, however the conclusions are limited by the small number of included studies and methodological differences. (C) 2015 Elsevier GmbH. All rights reserved.