Objective To conduct a Meta-analysis on the clinical efficacy and safety of acupuncture combined with acupoint application in the treatment of diarrhea-type irritable bowel syndrome(IBS-D), and to provide evidence for the clinical application of acupuncture combined with acupoint application in the treatment of IBS-D. Methods The literature on the treatment of IBS-D by acupuncture combined with acupoint application in the past 20 years was searched on databases such as CNKI, Wanfang, VIP, China Biomedical Literature Service System, Pubmed, etc. The original data was extracted and organized using Excel 2019. Jadad scale and Cochrane risk of bias assessment tool were used to assess the quality and risk of bias of the included studies. RevMan 5.3 was used for Meta-analysis. Results Ten RCT studies were included, which involves a total of 832 patients. Acupuncture combined with acupoint application has advantages over western medicine in overall response rate [RR=1.26, 95%CI(1.17, 1.36), P＜0.000 01], symptom score [SMD=-1.44, 95%CI(-2.16, -0.73), P＜0.000 01], and IBS-QOL [SMD=0.59, 95%CI(-0.14, 1.33), P＜0.000 1]. In terms of safety, 7 studies did not mention adverse reactions, 2 studies reported specific adverse reactions, and 1 study mentioned that there were no adverse reactions during the study. Conclusion Acupuncture combined with acupoint application therapy can enhance the curative effect of IBS-D, improve the clinical symptoms of patients, and improve the quality of life of patients compared with Western medicine. The safety of this treatment regimen cannot be evaluated at present, which requires further research and demonstration.