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Although patients experience some pain relief, these interventions may produce unacceptable side\u2010effects which inevitably affect the quality of life. Acupuncture may represent a potentially valuable adjunct to existing strategies for pain relief and it is known to be relatively free of harmful side\u2010effects. Although acupuncture is used in palliative care settings for all types of cancer pain the evidence\u2010base is sparse and inconclusive and there is very little evidence to show its effectiveness in relieving cancer\u2010induced bone pain (CIBP). The aim of this critical review is to consider the known physiological effects of acupuncture and discuss these in the context of the pathophysiology of malignant bone pain. The aim of future research should be to produce an effective protocol for treating CIBP with acupuncture based on a sound, evidence\u2010based rationale. 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