Objective This review aimed to systematically evaluate the evidence on the effects of acupoint catgut embedding （ACE） therapy for patients with polycystic ovary syndrome （PCOS）. Methods Five databases （CBM, CNKI, Wanfang Database, VlP Database, and PubMed） were searched to identify relevant studies published before June 2027. The outcomes were resumption of menstruation and serum levels of testosterone （T）. The methodological quality of the included studies was judged using the Cochrane risk of bias tool. The overall level of evidence was judged by the Grading of Recommendations Assessment, Development, and Evaluation （GRADE） criteria. Results Twenty- five randomized controlled trials were included. ACE therapy significantly lowered serum T levels, and patients receiving ACE treatment reported resumption of menstruation. However, these results should be interpreted with caution due to a high risk of randomization and blinding bias, and likely publication bias. The level of evidence for resumption of menstruation and serum T levels was assessed as ＂low＂ and ＂low＂, respectively, using GRADE. Conclusion The current evidence on ACE therapy for PCOS is insufficient to draw firm conclusions due to the poor methodological quality. Future well- designed trials are needed to validate the therapeutic efficacy, safety, and mechanisms of ACE in patients with PCOS.
