A PubMed search is carried out using the keyword "acupuncture" from in the top four journals: New England Journal of Medicine (NEJM), The Journal of American Medical Association (JAMA), The Lancet, and British Medical Journal (BMJ). The papers with full texts on randomized controlled trials (RCTs) of acupuncture are included up till July 2009, and the corresponding trial design and trial quality in these papers are extracted and analyzed. The results reveal that papers published in these four journals are mostly on randomized controlled trials with good design, high quality and large sample size. Therefore, if Chinese researchers publish papers in these journals, appropriate trial design adhering to the characteristics of acupuncture should be used; the results should be reported according to CONSORT statement and STRICTA recommendations. Moreover, obtaining assistance from foreign research team is also important.