Diabetic gastroparesis (DGP) is an important complication of diabetes, and seriously impacts the patient's quality of life. In the present paper, the authors summarize national and international research on the mechanism of acupuncture therapy in improving DGP and the pathogenesis of DGP over the past 10 years. The authors illustrate the mechanism of acupuncture underlying the improvement in DGP as follows:1) the effect on autonomic nerves and neurons of the central nervous system; 2) promoting restoration of the enteric nervous system; 3) the effect on Cajal interstitial cells; 4) improving gastrointestinal hormone disorder; 5) improving hyperglycemic state; 6) the effect on gastric smooth muscle. The authors also put forward some suggestions for future research on the mechanisms of acupuncture in DGP.