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OBJECTIVE: To systematically review and analyze the effect of acupuncture and acupoint catgut embedding in treatment of abdominal obesity to provide a more reasonable clinical treatment regimen. METHODS: Ten databases were searched as of August 2022: the English databases PubMed, Embase, Cochrane Library, Web of Science, Wiley, and Scopus and the Chinese databases China National Knowledge Infrastructure Database, China Science and Technology Journal Database, Wanfang, and SinoMed/Chinese Biomedical Literature Database. Randomized controlled trials (RCTs) of acupuncture and acupoint catgut embedding as the main interventions to treat abdominal obesity were extracted. The investigators imported the citations into EndNote version X9.1 for deduplication, screening, extraction, and integration. The risk of bias in the included RCTs was assessed according to the Cochrane Handbook. RevMan 5.4 software was used to conduct a Meta-analysis of RCTs that met the inclusion criteria. RESULTS: Thirteen RCTs (1069 patients) were included in this study, and the data of eleven RCTs (966 patients) were include in the Meta-analysis. The results showed that acupoint catgut embedding can significantly change the weight and waist circumference of patients with abdominal obesity when compared to sham acupuncture or no treatment [mean difference (MD) = 2.32, 95% confidence interval (CI) (1.88, 2.76), P < 0.000 01], [MD = 3.47, 95% CI (1.99, 4.94), P < 0.000 01]. The change in hip circumference after acupuncture was also significant [MD = 0.89, 95% CI (0.12, 1.66), P = 0.02]. CONCLUSION: This study found that acupuncture and acupoint catgut embedding can effectively treat abdominal obesity, therefore, these interventions can be used as clinical supplements and alternative therapies. The diagnostic criteria of the existing studies and the intervention measures of the control group are not unified. It will be necessary to improve the clinical study protocols and expand the sample size to further validate the reliability of the results obtained of this study.