Objective: To explore the role of acupuncture in cardiac anesthesia. Methods: We searched MeSH terms including "acupuncture", "electric acupuncture", "anesthesia", "heart surgery", "open chest surgery" in PubMed, CNKI, Wanfang Data, China Journal Net, Vipnet, Longyuan Journal Net and Springer Database. Randomized clinical trials regarding comparison between acupuncture-assisted anesthesia (AAA) and general anesthesia (GA) from January 1979 to January 2020 were obtained. The data quality of the enrolled studies was evaluated following Cochrane handbook with Review Manager 5.1.0 as the analysis tool. Results: Nine randomized, controlled studies were included. AAA was superior to GA in the following outcomes: elevated SpO(2) (Z = 17.13, P < 0.00001), longer length of stay in resuscitation room (Z = 80.81, P < 0.0001), higher mean arterial pressure (Z = 18.26, P < 0.0001) and Prince-Henry scores (Z = 40.23, P < 0.0001), reduced consumption of inhalation anesthetics (Z = 94.34, P < 0.0001) and intravenous anesthesia (Z = 130.86, P < 0.0001), lower postoperative VAS score (Z = 39.15, P < 0.0001), incidence of low blood pressure (Z = 3.31, P = 0.0009), postoperative nausea and vomiting (Z = 4.49, P < 0.0001), chills (Z = 3.31, P = 0.0009) and dysphoria (Z = 3.44, P = 0.006), and shortened extubation time in patients undergoing thoracotomy (Z = 66.87, P < 0.0001). Conclusion: Meta-analysis shows that AAA has beneficial clinical effects in open heart surgery. It can improve respiratory and circulatory functions, reduce the consumption of anesthetic drugs, extubation time, recovery time, pain intensity and adverse reactions in the early stage of anesthesia, which is suitable for thoracotomy.