Acupuncture anesthesia is a real and viable form of anesthesia with certain characteristics. Acupuncture anesthesia, also known as acupuncture anesthesia, refers to a unique method of anesthesia developed on the basis of acupuncture therapy. By stimulating a certain point or certain points with hand-twisted needles or electro-acupuncture to achieve analgesia, surgery can be performed without the use of anesthetic drugs. The modes of acupuncture anesthesia include single-needle anesthesia mode and needle drug anesthesia mode, of which needle drug anesthesia is the most widely used one at present. The mechanisms of acupuncture anesthesia include peripheral mechanisms, central mechanisms, and associated neurochemical transmitters. The peripheral mechanism is mainly based on acupuncture points and meridians, and the nerve impulses generated by the receptors of the corresponding acupuncture points after needling are transmitted through the peripheral nerves; the central mechanism is the integration of the afferent signals from the acupuncture points and the source of pain by the central nervous system. The neurochemical transmitters within the central nervous system that are antinociceptive are mainly endogenous opioid peptides, and the central nervous system produces the corresponding transmitters after receiving acupuncture signals, and then produces the corresponding analgesic effect. Acupuncture anesthesia is an innovative acupuncture modality developed on the basis of classical acupuncture, mainly for patients undergoing surgery. The research and clinical application of its mechanism is now more mature. It is recommended that patients who want to use acupuncture anesthesia during surgery consult with a professional doctor and use the method according to the specific condition, so as not to cause damage to the organism.