Background: Over time, Chinese medicine spread throughout Asia and developed into distinguishable styles of acupuncture in China, Japan, Korea and possibly Taiwan. Aims: This study sought to classify, clarify and describe acupuncture styles in China, Japan, Korea and Taiwan. Methods: A systematic search was conducted using: University of New England e-search resources, CINAHL (1998 to January 2015), ProQuest (1980 to January 2015), PubMed (1980 to January 2015) and Google Scholar (1980 to January 2015). Data was collated and coded into philosophical concepts, diagnostic methods and treatment principles. Patterns of relationships between styles were examined. Results: Twenty-eight articles met the inclusion criteria. Features of Chinese acupuncture include pattern identification and syndrome differentiation as well as the four diagnoses. The solicitation of 'De-qi' during needle stimulation is typical. Although encompassed in Chinese acupuncture as well, emphasis in Japanese acupuncture is placed on the theory of five phases, meridians and collaterals, palpation and relatively light needle stimulation. Korean acupuncture is based on a constitutional model and uses systematic treatments with substance injection into body loci and microsystem acupuncture. Taiwanese acupuncture was described as analogous to Chinese acupuncture. Conclusion: There is a variable degree of consistency and reliability in the literature addressing acupuncture styles internationally. There appears to be a common pool of philosophical concepts, Chinese in origin, which are fundamental across all styles and have influenced the respective diagnostic methods and treatment principles in varying degrees. Japanese and Korean acupuncture styles have evolved from this, whereas details of a Taiwanese acupuncture style is limited and is assumed to be Chinese.