Objective <p>To systematically evaluate and compare the effectiveness of laser acupuncture in managing headaches.</p> Methods <p>Indexed databases, including PubMed, Excerpta Medica Database, Web of Science, Scopus, and Cochrane Library, were independently searched for randomized controlled trials (RCTs) published until April 2025. The risk of bias across individual studies was assessed using the Cochrane risk of bias tool for interventions.</p> Results <p>Out of the initial 1 861 manuscripts, 5 RCTs met the selection criteria. The protocols were similar across the studies, but the characteristics of the laser and acupuncture, outcome measurements, treatments, and assessment sessions varied. In the 5 included clinical trials, there was a more significant improvement in pain intensity and headache severity with laser acupuncture than in the control group at each time point. Four studies demonstrated a substantial decrease in the headache duration from baseline after laser acupuncture. One RCT reported laser acupuncture as a safe and non-invasive treatment in children. In another trial, it was also found to reduce tension-type headache with pericranial tenderness, enhance antioxidant status, and decrease oxidative stress markers, resulting in an improvement in the psychological status of the individual.</p> Conclusion <p>Laser acupuncture is a non-invasive treatment modality for headaches. Some protocols could reduce the pain intensity and duration of headache attacks. However, more extensive and robust clinical trials are needed to validate the results.</p>