The purpose of this study was to evaluate the short-term efficacy of dry needling therapy in patients severely affected by fibromyalgia. One hundred and twenty fibromyalgia patients were randomly divided into two groups. The control group, 56 women and 4 men, and the dry needling group, 54 women and 6 men, who apart from continuing their medical treatment, also underwent weekly 1-h session of dry needling for 6 weeks. At the beginning of the program, there were significant differences in the age (mean 56.26 years in the dry needling group versus 50.82 years in controls, p = 0.01) and McGill Pain Questionnaire [MPQ] (mean 39.07 in dry needling group versus 42.44 in controls, p = 0.03). At the end of treatment, the experimental group showed significant differences in most tests, including Visual Analogue Scale (VAS) of pain (p = 0.002), VAS of fatigue (p = 0.02), pain of Medical Outcomes Survey Short Form-36 (SF-36) (p = 0.0007), myalgic score (p = 0.0005), pressure pain threshold (p = 0.002), and global subjective improvement (p = 0.00001). Six weeks after the end of the treatment, the dry needling group still showed significant differences in most tests, including VAS of pain (p = 0.01), VAS of fatigue (p = 0.02), pain of SF-36 (p = 0.01), myalgic score (p = 0.00001), pressure pain threshold (p = 0.0004), and global subjective improvement (p = 0.00001). In conclusion, patients severely affected by fibromyalgia can obtain short-term improvements following weekly dry needling for 6 weeks.