[Objective] This study aimed to collect, analyse, and examine the literature on adverse events in acupuncture and moxibustionin order to improve safety.[Subjects and Methods] A literature search was conducted using Ichushi Web and PubMed to identify reports of adverse eventsrelated to acupuncture and moxibustion published in domestic and international medical journals from 2020 to 2023. The searchkeywords included 'acupuncture', 'moxibustion', and various terms related to adverse events associated with them.[Results] We identified 33 papers describing acupuncture-related adverse events in Japan. The reported adverse events includedinfections (9 papers), organ injuries (11), neurological injuries (2), dermatological problems (2), and needle breakage, retainedneedles, or foreign bodies (9). We also identified 56 papers reporting adverse events that occurred abroad, including infections(17); organ injuries (23); neurological injuries (1); dermatological problems (6); needle breakage, retained needles or foreignbodies (3); others (4); and moxibustion-related adverse events (2).[Conclusion] Consistent with previous surveys, various adverse events related to acupuncture and moxibustion occurred bothdomestically and internationally. These findings highlight the importance of learning from the reported cases and implementingsafety education on acupuncture and moxibustion.Zen Nihon Shinkyu Gakkai Zasshi (Journal of the Japan Society of Acupuncture and Moxibustion: JJSAM).2025; 75(4): 442-462. Received 29 Jun, 2025 Accepted 13 Jul, 2025

The safety committee has been undertaking activities, such as conducting regular workshops at the annual congresses, managing the "Safety Measures Website for Acupuncture and Moxibustion," researching the literature, conducting multicenter prospective studies on acupuncture and moxibustion-related adverse events, collecting information about medical accidents involving acupuncture and moxibustion in Japan, addressing the media pertaining to false information regarding the safety of acupuncture and moxibustion, and formulating the Safety Guidelines for Japanese Acupuncture and Moxibustion Practice. At the 71st annual Tokyo congress workshop, activities conducted over the past decade were summarized.　Regarding the studies on acupuncture and moxibustion-related adverse events, a literature review of reports concerning acupuncture- and moxibustion-associated adverse events published globally from 2004 to 2019 was introduced. Furthermore, the results of a multicenter prospective study conducted by the safety committee were also introduced. Additionally, the Safety Guidelines for Japanese Acupuncture and Moxibustion Practice were introduced, and the results of a questionnaire survey determining the degree of recognition of these guidelines were simultaneously reported. Moreover, regarding future developments, plans to create and publish a safety manual for acupuncture and moxibustion (provisional name) were reported.　In the second half of the workshop, reports on the past cases of needle breakage and retained needles were introduced under the topic "precautions and preventive measures regarding needle breakage and retained needles." Furthermore, the number of needle breakage claims filed under the liability insurance of acupuncture and moxibustion practitioners was reported. These details demonstrate that despite the common use of single-use acupuncture needles, accidents involving needle breakage still exist. Lastly, measures for reducing the difficulty in needle removal and preventing needle breakage were summarized, and opinions on the same were exchanged with the participants.