Evidence of practices similar to acupuncture are found in Chinese relics dating back to the New Stone Age (8000-2000 B.C.). During this time the first acupuncture needles were crudely shaped and made from stone. Known as bian stones, they were used to apply pressure to the body, treat wounds, and lance infectious lesions. Later, needles replaced the bian stones. The first written reference to acupuncture is found in The Yellow Emperor's Inner Cannon of Medicine (Nei Ching Sue Wen) written in approximately 200 B.C., but assumed to include writings from much earlier times. There are numerous sections in Nei Ching Sue Wen, addressing core subjects of medicine such as the physiological constitution of the body, diagnosis, fevers, and treatments (including acupuncture) based on the wisdom and experience of earlier sages. The work contains a dialogue between the ancient "yellow emperor" Huang-yi (c. 2650 B.C.) and his chief minister thatsets down the philosophical basis of traditional Chinese medicine embraced by acupuncture.

Traditional Chinese medicine holds that the body contains an essential life energy known as qi (pronounced "chee"). Chinese language scholars maintain that the concept of qi is greater than any type of energy described by Western science. Qi was described in the Nei Ching Sue Wen as being responsible for change, movement, and life itself. All mental and physical aspects of life were made possible by the flow of qi throughout the body. Qi flowed through the body in channels or meridians which were arranged in a mostly symmetrical pattern. There were 14 main meridians running up and down the length of the body. Early references portray the meridians as nonphysical, unique energy pathways in the body. When the pathways became obstructed or inefficient, the flow of qi was interrupted and an imbalance in the body could occur, resulting in illness. Traditional Chinese physicians practiced acupuncture to restore that balance.