Background: Urticaria is very common and most of the current treatments are only partially successful. Objective: As the efficacy of acupuncture in the treatment of chronic urticaria has not been studied in Iran, we decided to do this study. Patients and Methods: In a randomized, controlled, double-blind clinical trial, 40 patients with chronic urticaria referred to skin clinics of Isfahan University in 1378 were studied. The patients had idiopathic urticaria, resistant to conventional treatment, and had not received any medication in the last month. We randomly divided them in two equal groups. One group was treated with acupuncture and the other with placebo for 3 weeks. Data entry and analysis was performed by Systat and T-test was used for data analysis. Results: The mean numbers of the episodes of urticaria in 3 weeks were 4.81 times in the control group and 3.62 times in the acupuncture group (P=0.01). The mean duration of urticarial episodes in the third week was 5.08 hours in the control group and in received acupuncture group was 2.37 hours in the acupuncture group (P=0.03). Conclusion: Acupuncture induced remission of chronic urticaria in the majority of the patients. Its efficacy was greatest in the third week of treatment.