Primary dysmenorrhea—painful menstrual cramps without underlying pathology—is one of the most common gynecological complaints among women of reproductive age. While nonsteroidal anti-inflammatory drugs (NSAIDs) remain the standard first-line treatment, many individuals seek alternative therapies such as acupuncture for symptom relief with fewer side effects. This literature review explores the efficacy of acupuncture in the management of primary dysmenorrhea, comparing outcomes with NSAIDs, sham acupuncture, and no treatment. While research in English is somewhat limited, three relevant randomized controlled trials (RCTs) were reviewed for this discussion.