Objective: This study aimed to systematically evaluate the effect of electroacupuncture (EA) on postoperative gastrointestinal function recovery and provide evidence-based support for its clinical application. Methods: PubMed, MEDLINE, Web of Science, Cochrane Library, and EMBASE were searched for randomized controlled trials (RCTs) published from database inception to October 25, 2025. Eligible studies were screened according to predefined criteria. Study quality was assessed using the Risk-of-Bias (ROB) 2.0 tool. Meta-analysis was conducted using RevMan 5.3 and STATA 18.0. Results: Eight RCTs involving 1,086 participants were included. Overall study quality was high, with no studies assessed as having a high risk of bias. Meta-analysis showed that compared with control interventions, EA significantly shortened the time to first flatus (MD = −6.72, 95% CI −12.11 to −1.34, P = 0.01), first defecation (MD = −12.60, 95% CI −17.01 to −8.19, P < 0.001), and first bowel sound (MD = −4.50, 95% CI −7.14 to −1.87, P < 0.001). High heterogeneity was observed for time to first flatus, while heterogeneity was moderate or absent for other outcomes. Egger's test indicated no significant publication bias (P > 0.05). Sensitivity analyses confirmed the robustness of the results. Subgroup analyses suggested that a needle retention time of 30 min may contribute to heterogeneity. Conclusion: EA significantly promotes postoperative gastrointestinal function recovery by shortening key recovery times. Despite heterogeneity in some outcomes, the overall findings are stable and support EA as a beneficial intervention for postoperative gastrointestinal rehabilitation.
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