[Objective] To investigate effect on symptoms and safety of acupuncture and moxibustion for cancer-related fatigue.[Participants and methods] The subjects of the study were cancer patients hospitalized in palliative care who were treated with acupuncture for fatigue during the period from April 20XX-5 to October 20XX. Medical records were examined retrospectively. The main items investigated were changes in the symptom item of the STAS-J scores before and after the start of acupuncture treatment, and the frequency of adverse events.[Results] Thirty patients (14 women) were eligible for the study. All patients received standard palliative care. STAS-J improved within one week after the start of acupuncture treatment in 17 cases (56.7%), remained unchanged in 13 cases, and worsened in none of the cases. The number of acupuncture treatments was 14 per patient (median), for a total of 514 total treatments. No adverse events as defined by acupuncture safety guidelines were observed.[Conclusion] This report does not evaluate the impact of acupuncture alone because palliative care involves multidisciplinary care. However, the symptom item of the STAS-J improved in 56.7% of cases within one week after the start of acupuncture treatment, no cases worsened, and no adverse events were observed. Acupuncture and moxibustion is one of the methods worth trying in cases where symptoms of cancer-related fatigue do not improve with standard palliative care.