Objective This study was designed to systematically evaluate the efficacy of acupuncture and moxibustion for cancer-related fatigue(CRF). Methods Eight databases(EMbase, Web of Science, The Cochrane, CBM, CNKI, VIP and WanFang Data) were electronically searched to collect randomized controlled trials(RCTs) on acupuncture and moxibustion for cancer related fatigue from inception to March, 2020. Two reviewers critically and independently assessed the risk of bias using Cochrane Collaboration criteria and extracted correlated data using the designed form. All analyses were performed with Review Manager 5.3 software. Results Eleven RCTs were included for meta-analysis, involving a total of 832 subjects. The results of meta-analysis showed that, acupuncture and moxibustion had a marked effect on fatigue in cancer patients compared with the control group[SMD=-1.06，95%CI(-1.73，-0.40), P=0.002]. The meta-analysis also indicated that for patients who had finished anti-tumor treatment, the acupuncture effect is more significant[SMD=-1.00， 95%CI(-1.87,-0.12)，P=0.03]. The effect of acupuncture on improving the quality of life of patients is inaccurate[SMD=0.26，95%CI(-0.03, 0.55), P=0.08]. During follow-up period, 2-4weeks after finishing treatment, no improvements in fatigue symptoms were found[SMD=-0.85，95%CI(-2.86,1.16)，P=0.41]. Conclusion Current evidence shows that acupuncture and moxibustion can effectively relieve fatigue symptoms in cancer patients, especially for those who have finished anti-tumor therapy and rarely have adverse effects. However obvious effects are not found on improving the quality of life of patients and on relieving fatigue symptoms during follow-up period. Due to limited quality of the included studies, more higher quality studies are required to verify above conclusion.