Acupuncture has been an integral part of Traditional Chinese Medicine for thousands of years. It has been used for the treatment of many painful and nonpainful conditions. Its use within Western medicine has increased since the 1970s and acupuncture is now practiced by a variety of healthcare practitioners across Europe. There is an accepted body of evidence to support the use of acupuncture for back or neck pain. Anecdotal evidence from both clinicians and patients suggests there may be some beneficial effect of acupuncture in the treatment of respiratory symptoms, such as bronchospasm, breathlessness and hyperventilation syndromes. Some respiratory clinicians are introducing acupuncture as a treatment modality for the management of respiratory symptoms, despite the lack of available objective evidence to support this practice. This article reviews the available evidence for the use of acupuncture in respiratory disorders and provides discussion of the methodological issues that are evident within this literature. It also highlights reasons for the lack of objective evidence to support acupuncture for respiratory conditions and the difficulties faced by acupuncture researchers when designing randomized, placebo-controlled trials. Currently, there is insufficient evidence to support a recommendation for the use of acupuncture in respiratory disorders.