To evaluate the effectiveness of acupuncture in treating anxiety and depression in patients with functional dyspepsia (FD) through a meta-analysis. Methods: From database inception to January 2024, seven databases—CNKI, Wanfang, VIP, SinoMed, PubMed, Web of Science, and Embase—were searched for randomized controlled trials (RCTs) related to acupuncture for anxiety and depression in FD. Revman 5.3 and Stata 17.0 were used for outcome analysis. Results: A total of 832 FD patients were included (416 in the treatment group, 416 in the control group). Compared with the control group, acupuncture significantly improved SAS [MD=－0.55, 95% CI (－1.01, －0.10)], SDS [MD=－1.18, 95% CI (－1.84, －0.52)], HADS [MD=－3.01, 95% CI (－4.73, －1.29)], dyspepsia symptom score [MD=－1.55, 95% CI (－2.04, －1.07)], and total effective rate [MD= 2.62, 95% CI (1.70, 4.01)]. For HAMA [MD=－4.73, 95% CI (－11.59, 2.12)] and HAMD [MD=－4.35, 95% CI (－9.15, 0.44)], the differences were not statistically significant as the confidence intervals crossed zero. Conclusion: Acupuncture can improve both symptoms and anxiety/depression in patients with functional dyspepsia; however, the level of evidence remains low.