The acupoint area,as the initial response site to acupuncture,is the origin of acupuncture effect.The change in the acu-point microenvironment caused by acupuncture is the key initiating step for the manifestation of its effect.Clarifying the initiation mechanism of acupuncture can further promote the clinical application of acupuncture.Through a review of relevant research litera-ture on acupoint acupuncture,this paper finds that the changes in connective tissue in the acupoint microenvironment are closely re-lated to acupuncture effect,and fibroblasts,mast cells and macrophages within the connective tissue play an important role in the in-itiation of acupuncture effect.However,the basic research on the initiation mechanism of acupuncture at acupoint sites is scattered and not systematic.Further in-depth research on the initiation mechanism of acupuncture at acupoint sites can provide a basis for the clinical application of acupuncture.There is still considerable room for future exploration and research in this area