Abstract：Objective：To evaluate the effectiveness and safety of warming-needle moxibustion in the treatment of primary dysmenorrhoea. Methods：The systematic review and Meta-analysis were conducted according to PRISMA guidelines. Randomized controlled trials from the establishment time of the databases to May 2023 were collected from PubMed， Web of Science， EMBASE， Cochrane Library， CNKI， VIP， Wanfang， and China Biomedical Database. All the obtained data were analyzed by Review Manager 5.4. Results：Warming-needle moxibustion for primary dysmenorrhea has a better effect in in the treatment of enhancing clinical effects {risk ratio (RR) =1.21，95% confidence interval (CI) [1.16，1.25]，P＜0.000 01}， improving resistance index (RI) {mean difference (MD) =-0.14， 95%CI[-0.19， -0.08]， P＜0.000 01}， pulse index (PI) (MD=-0.55， 95%CI[-0.69， -0.40]， P＜0.000 01)， β -endorphin (β -EP) {standardized mean difference (SMD)=1.36，95%CI[0.90，1.82]，P＜0.000 01}，dysmenorrhea syndrome scores (MD= -1.82， 95%CI[-2.77， -0.87]， P=0.000 2)，and Visual Analogue Scale (VAS) scores of pain (MD=-1.16， 95%CI[-1.48，-0.83]，P＜0.000 01) when compared with routine treatment alone， and the incidence of adverse reactions was lower than that in the control group (P=0.01). The results of the evaluation of the quality of evidence showed that the clinical effect was intermediate， and most of the others were low. Conclusion： Warming-needle moxibustion for primary dysmenorrhea has a definite curative effect with certain safety.