Abstract：Objective：To systematically evaluate the therapeutic effect and safety of acupoint injection in treating refractory facial paralysis through a Meta-analysis. Methods： Randomized controlled trials （RCTs） on acupoint injection for refractory facial paralysis were searched in Wanfang， CNKI， VIP， SinoMed， PubMed， Cochrane Library， and Embase from their establishment days to July 9， 2024. Literature was screened based on inclusion and exclusion criteria，and target data were extracted. The quality of included studies was assessed using the Cochrane Risk of Bias Tool. Rev-Man 5.4 software was used for Meta-analysis of total effective rate， marked recovery rate， and House-Brackmann Facial Nerve Function Grading Scale（ H-B Scale） scores. Results：Ten studies involving 645 patients with refractory facial paralysis were included. The Meta-analysis showed that acupoint injection significantly outperformed the control group in clinical outcomes：total effective rate [OR=4.42，95%CI（ 2.55，7.67），P＜0.000 01]， marked recovery rate [OR=3.84， 95%CI （2.64， 5.58）， P＜0.000 01]， and H-B Scale scores [MD=-0.87， 95% CI （-1.38， -0.36）， P=0.000 8]. Conclusion： Acupoint injection demonstrates significant clinical effect and high safety in treating refractory facial paralysis.