Background:To explore the efficacy and safety of electroacupuncture (EA) for secondary insomnia through a meta-analysis and a systematic review.Methods:The CNKI, Wanfang, VIP database, Web of Science, EMBASE, PubMed, and Cochrane Library were retrieved. The retrieval date was February 28, 2023. Two independent reviewers conducted literature screening, data extraction, and risk of bias (ROB) assessment. The revised Cochrane ROB tool was used to assess the ROB in included studies. Data analysis was performed using RevMan 5.4 software and Stata 15.0.Results:Thirteen randomized controlled studies were included, involving 820 patients, including 414 patients in EA group and 406 patients in the control group. Compared with the control group, EA could improve secondary insomnia overall responses (relative risk = 3.90, 95% confidence interval [CI] [1.87, 8.13],P< .001), reduce Pittsburgh Sleep Quality Index score (mean difference [MD] = −2.26, 95% CI [−4.14, −0.37],P= .02), reduce Athens Insomnia Scale score (MD = −0.57, 95% CI [−2.70, 1.56],P= .60), prolonged total sleep time (MD = 2.63, 95% CI [−0.59, 5.86],P= .11), and not increase adverse events (relative risk = 0.50, 95% CI [0.18, 1.44],P= .20).Conclusion:EA may be a promising treatment for secondary sleep disorders; however, more high-quality studies are needed to confirm our findings.