Abstract: Acupuncture, a traditional Chinese medical therapy, is undergoing a progressive intelligent transformation driven by modern technology. The integration of contemporary technology with traditional acupuncture has resulted in the evolution of smart acupuncture equipment. This evolution has transformed acupuncture from a diagnostic and therapeutic tool into an intelligent system encompassing a wide range of applications, including precision diagnosis, treatment and health management. This paper presents a systematic review of core technological advancements in smart acupuncture equipment, including perception and positioning, decision-making and intelligent algorithms, and execution and control. Furthermore, it delineates the contemporary state of research and development for innovative equipment such as smart acupuncture robots and intelligent acupuncture treatment units. Concurrently, it analyses challenges constraining development, such as multidisciplinary talent shortages, incomplete industry standards, low research-to-practice conversion rates, and data security concerns. A number of strategies are proposed for advancing further development, including medical-engineering integration, standardisation initiatives, translational medical research, and data governance.