BACKGROUND & AIMS:: We investigated the efficacy of electroacupuncture in reducing the duration of postoperative ileus and hospital stay after laparoscopic surgery for colorectal cancer. METHODS:: We performed a prospective study of 165 patients undergoing elective laparoscopic surgery for colonic and upper rectal cancer, enrolled from October 2008 to October 2010. Patients were randomly assigned to groups that received electroacupuncture (n = 55) or sham acupuncture (n = 55), once daily from post-operative days 1-4, or no acupuncture (n = 55). The acupoints Zusanli, Sanyinjiao, Hegu, and Zhigou were used. The primary outcome was time to defecation. Secondary outcomes included postoperative analgesic requirement, time to ambulation, and length of hospital stay. RESULTS:: Patients that received electroacupuncture had shorter time to defecation than patients that received no acupuncture (85.9 ±3 6.1 vs 122.1 ± 53.5 hours, P < .001) and length of hospital stay (6.5 ± 2.2 vs 8.5 ± 4.8 days, P = .007). Patients that received electroacupuncture also had shorter time to defecation than patients that received sham acupuncture (85.9 ± 36.1 vs 107.5 ± 46.2 hours, P = .007). Electroacupuncture was more effective than no or sham acupuncture in reducing postoperative analgesic requirement and time to ambulation. In multiple linear regression analysis, an absence of complications and electroacupuncture were associated with shorter duration of postoperative ileus and hospital stay after the surgery. CONCLUSIONS:: In a clinical trial, electroacupuncture reduced duration of postoperative ileus, time to ambulation, and postoperative analgesic requirement, compared with no or sham acupuncture, after laparoscopic surgery for colorectal cancer.