Objective. We aim to investigate the efficacy of acupuncture for acute migraine attacks comparing with sham acupuncture. Design. The study was designed as a multicenter, single-blinded, randomized controlled clinical trial. Setting and Patients. From March 2007 to February 2009, 150 patients were randomly allocated to verum or sham acupuncture group in a ratio of 1:1. Interventions. Every patient received a verum or sham acupuncture treatment when having a migraine attack and, medications were allowed if the pain failed to be relieved two hours after the acupuncture. Outcome Measures. The primary outcome was visual analog scale (VAS) scores for pain, ranging from 0 (no pain) to 10 (worst pain ever). Results. The mean VAS scores 24 hours after treatment decreased from 5.7 +/- 1.4 to 3.3 +/- 2.5 in the verum acupuncture group, and from 5.4 +/- 1.3 to 4.7 +/- 2.4 in the sham acupuncture group. Significant differences existed between the two groups (P = 0.001). Conclusions. This trial suggested that verum acupuncture group was superior to sham acupuncture group on relieving pain and reducing the usage of acute medication.