Objectives: To review trials on the efficacy and safety of auricular acupuncture (AA) treatment for insomnia and to identify the most commonly used auricular acupoints for treating insomnia in the studies via a frequency analysis.Data sources: The international electronic databases searched included: (1) AMED;(2) the Cochrane library; (3) CINAHL; (4) EMBASE; and (5) MEDLINE. ยฎ Chinese electronic databases searched included: (1) VIP Information; (2) CBMdisc; and (3) CNKI.Study selection: Any randomized controlled trials using AA as an intervention without using any co-interventions for insomnia were included. Studies using AA versus no treatment, placebo, sham AA, or Western medicine were included.Data extraction: Two (2) independent reviewers were responsible for data extraction and assessment. The efficacy of AA was estimated by the relative risk (RR) using a meta-analysis.Results: Eight hundred and seventy eight (878) papers were searched. Six (6) trials (402 treated with AA among 673 participants) that met the inclusion criteria were retrieved. A meta-analysis showed that AA was chosen with a higher priority among the treatment subjects than among the controls (p ฯฝ 0.05). The recovery and improvement rates produced by AA was significantly higher than those of diazepam (p ฯฝ 0.05). The rate of success was higher when AA was used for enhancement of sleeping hours up to 6 hours in treatment subjects (p ฯฝ 0.05). The efficacy of using Semen vaccariae ear seeds was better than that of the controls (p ฯฝ 0.01); while magnetic pearls did not show statistical significance (p ฯญ 0.28). Six (6) commonly used auricular acupoints were Shenmen (100%), Heart (83.33%), Occiput (66.67%), Subcortex (50%), Brain and Kidney (each 33.33%, respectively).Conclusions: AA appears to be effective for treating insomnia. Because the trials were low quality, further clinical trials with higher design quality, longer duration of treatment, and longer follow-up should be conducted.