Objective To investigate the clinical application of acupuncture in the treatment of transient ischemic attack(TIA). Methods The electronic databases of CNKI, Wanfang, VIP and PubMed were searched. Excel was used for descriptive statistical analysis, SPSS Clementine 12.0 was used for association rule analysis and SPSS 26.0 was used for cluster analysis. Results A total of 60 acupuncture prescriptions were included, and 47 acupoints were selected. The top 5 acupoints were Baihui(GV20), Fengchi(GB20), Xiangjiaji, Dazhui(GV14) and Fengfu(GV16). The most acupoints were on the Du meridian, mostly on the head and neck, and special acupoints such as rendezvous were selected. The top four combinations of acupoints were Baihui-Fengfu, Dazhui-Yamen(GV15), Baihui-Yamen(GV15) and Baihui-Yamen(GV15)-Dazhui, and the high-frequency acupoints were grouped into five categories. Conclusion In clinical acupuncture treatment of TIA, acupoint selection is mainly at the head, and the acupoint selection principle of proximal acupoint selection, meridian acupoint selection and distal acupoint selection is mostly adopted. Attention should be paid to activating Yang Qi, refreshing the brain and opening the orificiaries, nourishing Qi and blood.