This article systematically reviewed the development of acupuncture education in the United States over the past fifty years，analyzing the reasons for its fluctuations and the challenges it faces.Through case studies of the establishment，development，mergers and closures of various acupuncture schools，the article revealed the development model of the acupuncture education industry and its susceptibility to changes in policies，economic environment and market demand.In particular，after the implementation of the“gainful employment”rule，some schools faced a decrease in enrollment and financial pressures，leading to their closure.The deficiencies in teaching systems and research innovation in acupuncture education，the rise of dry needling techniques，and the changes in industry standards have also had a profound impact on the survival of these schools.This article aimed to provide insights and considerations for the sustainable development of acupuncture education in the future through an analysis of these factors.

acupuncture education  /  accreditation  /  gainful employment  /  private schools  /  dry needling  /  school closures  /  policy impact