Seventy percentage of perimenopausal and early postmenopausal women will experience menopause symptoms. Primary menopause symptoms in Western countries included hot flashes, insomnia, somatic pain, depression, and fatigue. Hot flashes were most commonly treated. Menopausal hormone replacement therapy (HRT) continues to have a clinical role in the management of vasomotor symptoms, but since 2002 there has been a marked global decline in its use due to concerns about the risks and benefits of HRT; consequently many women with menopause symptoms are now seeking alternatives including acupuncture. Acupuncture has a long tradition of use for the treatment of different menopause symptoms. Its effectiveness has been studied for natural menopause or chemical and surgery induced menopause. Here we provide an update on recent advances in the field for clinicians. The recent systematic reviews on acupuncture in menopausal symptoms suggest that acupuncture is an effective and valuable option for women suffering from menopause. However, the science of acupuncture therapies is still inadequate to sufficiently support the benefits of acupuncture therapies. Finally, we discuss our points of view on clinical trials of acupuncture for menopause symptoms.