In the present paper, the authors review the development of researches on acupuncture therapy with functional magnetic resonance imaging (fMRI) in recent 5 years in both China and foreign countries. The current researches mainly involve 1) specificity of efficacies of acupoints, 2) mechanisms of acupuncture intervention underlying improvement of various clinical conditions or illnesses, 3) individual difference of the subjects, and 4) sustained efficacies of acupuncture. In the early stage, researches on acupuncture therapy mostly focus on the immediate efficacy and the specificity of efficacies of acupoints. Along with the actuality of sustained effect of acupuncture, new test design paradigms agreeable with clinical practice are necessary in the future. In addition, more attentions about the stability of the tested results should be paid.