Background Acupuncture is a safe and well-tolerated treatment for pain relief. Previous studies supported the effectiveness of several acupuncture techniques for postoperative pain. The aim of this randomized, controlled trial was to evaluate the efficacy of acupuncture in reducing pain after thyroid surgery. Methods We randomized 121 patients to a control group (undergoing only standard postoperative analgesic treatment with acetaminophen) and an acupuncture group, undergoing also either electroacupuncture (EA) or traditional acupuncture (TA). Pain was measured according to intraoperative remifentanil use, acetaminophen daily intake, Numeric Rating Scale (NRS), and McGill Pain Questionnaire on postoperative days (POD) 1–3. Results Acupuncture group required less acetaminophen than controls at POD 2 ( P  = .01) and 3 ( P  = .016). EA patients required less remifentanil ( P  = .032) and acetaminophen than controls at POD 2 ( P  = .004) and 3 ( P  = .008). EA patients showed a trend toward better NRS and McGill scores from POD 1 to 3 compared with controls. EA patients had a lower remifentanil requirement and better NRS and McGill scores than TA patients. No differences occurred between TA patients and controls. Conclusion Acupuncture may be effective in reducing pain after thyroid surgery. EA is more useful; TA achieves no significant effects.