Premenstrual dysphoric disorder (PMDD), a severe type of premenstrual syndrome (PMS), is characterized mainly by psychological symptoms confined to the premenstrual period, which reduce not only patients' quality of life, but also their working activities. Although various therapies have been employed for PMDD, some patients do not respond to them. We recently employed acupuncture treatment for a patient in PMDD. Symptoms ameliorated during the acupuncture (+) period, but deteriorated during the acupuncture (-) period. This review describes the clinical course of this case. The diagnosis and treatment of PMDD are briefly summarized and previous acupuncture treatment for PMS are reviewed. The difficulties in evaluating the effectiveness of acupuncture for PMS/PMDD are addressed. It is suggested that acupuncture may be a treatment option for PMDD.