Eighty-two patients with external humeral epicondylitis were randomized to receive either extracorporeal shockwave therapy (ESWT) with warm acupuncture (n=41) or extracorporeal shockwave therapy alone (n=41). The primary outcome of interest was pain on a Visual Analog Scale after treatment and at 1 and 3 months. Secondary outcomes of interest included Mayo Elbow Performance (MEPS), Disabilities of the Arm, Shoulder, and Hand (DASH), interleukin-6 (Il-6), interleukin-10 (IL-10), and tumor necrosis factor (TNF-a) levels. Lastly, diagnostic efficacy was also assessed. Pain scores were significantly better in the EWST + warm acupuncture group at 4 weeks, 1 month, and 3 months after treatment. Similarly, MEPS and DASH scores were also significantly better at all time points in the EWST + warm acupuncture group. Il-6, IL-10, TNF-a, and clinical effectiveness were also significantly better in the EWST + warm acupuncture group after treatment.