Objective To evaluate the efficacy and safety of scalp acupuncture in the treatment of ischemic stroke. Methods The method recommended in the Cochrane Collaboration was used for the systematic evaluation of the randomized controlled trials (RCTs) of scalp acupuncture in the treatment of ischemic stroke. Results One thousand three hundred and ninety-five cases from 13 papers in Chinese version were in compliance with the inclusive criteria and all of them were the low-quality trials. The results of the included 5 trials in Meta analysis indicated that the efficacy of scalp acupuncture was superior to medication in the treatment of ischemic stroke (RR=1.27, 95% CI 1.06, 1.51). The results of 3 trials in Meta analysis suggested that the recovery in the nerve function defect of the patients with ischemic stroke treated with scalp acupuncture was apparent as compared with medication (WMD = -2.96, 95% C1-4.00, -1.92). The results of 5 trials in Meta analysis showed that the efficacy of scalp acupuncture on ischemic stroke was potentially superior to body acupuncture (RR=I.10, 95% CI 0.93, 1.28). Conclusion It is seen in the Meta analysis results of the included 13 RCTs that scalp acupuncture achieves the definite efficacy on ischemic stroke. Due to the limitation of the inclusive numbers and quality of the research, especially the lack of long-term indices, the conclusion reliability of this research is relatively low. Hence, it is required much more evidences for a further confirmation from the large scale and multiple central RCTs with high quality and intrinsic authenticity.