Eleven randomized controlled trials were included in this systematic review and meta-analysis which investigated the efficacy of trigger point dry needling for shoulder and upper extremity pain associated with myofascial trigger points. Two studies compared trigger point dry needling of active and latent trigger points to trigger point dry needling of active trigger points alone; meta-analysis demonstrated a greater reduction in pain and increase in pressure pain threshold among groups administered dry needling of both active and latent trigger points. Meta-analysis of these studies demonstrated no significant difference in increase in grip strength. Among the other studies, the majority demonstrated positive effects of trigger point dry needling compared to either inactive or other active control interventions for pain (7 of 9 studies) and functional scores (2 of 3 studies).