To evaluate the effectiveness of acupuncture analgesia (AA) compared with combined spinal-epidural anesthesia (CSEA) for labor pain relief and labor outcomes. We evaluated 131 primiparous women who received respiratory guidance during maternal uterine contractions and received either AA (n = 43), CSEA (n = 45), or no additional treatment (control, n = 43). The groups were compared regarding visual analog scale (VAS) scores for abdominal and back pain, and labor outcomes. The abdominal VAS scores of the AA and CSEA groups were significantly lower than that of the control group. In addition, the VAS scores of the CSEA group were significantly lower than that of the AA group at 10 and 60 min after intervention. The back pain VAS scores of the AA and CSEA groups were significantly lower than that of the control group at 5, 10, and 60 min after intervention. The duration of the active phase of labor in the CSEA group was significantly longer than that of the AA and control groups. The rates of oxytocin use (4.70%), urinary retention (4.70%), and postpartum hemorrhage [(273.7 ± 53.6) mL] in the AA group were significantly lower than in the CSEA group [46.70%, 24.20%, and (320.0 ± 85.6) mL, respectively]. Both AA and CSEA were effective for labor pain relief, CSEA provided more effective pain relief, while AA was associated with a shorter duration of labor and fewer adverse effects.and each has its advantages and disadvantages.