Acupuncture has a long history and has changed throughout centuries of practice. Many scholars have shown interest in the recent changes in acupuncture practice in China, but little is known about the Taiwanese case. Our aim is to analyze the development of Taiwanese acupuncture practice and to show how this technique was transformed in connection with political, economic and socio-cultural events. This paper starts with a historical review, covering 1949 until today, to highlight the most prominent events related to acupuncture. Then, through an analysis of the descriptions of needle insertion techniques in five representative acupuncture textbooks and guideline publications, we aim to illustrate the changes appearing in the way the needle is inserted and held.The institutionalization of acupuncture began with the creation of a Chinese medicine department at the China Medical College in 1966. However, it is the ""acupuncture fever"", in 1972, which pushed acupuncture to the front stage and triggered the development of acupuncture research. This event speeded up the creation of acupuncture departments in hospitals. Finally, in 1995, acupuncture treatments became covered by the National Health Insurance. The inclusion of acupuncture into institutions based on a biomedical healthcare system led to the establishment of standards for holding and inserting the needles and facilitated the adoption of disposable needles with tube. A strong focus was put onto maintaining a sterile environment and the physicians became required to avoid touching the needle body with bare hands to avoid contamination. This resulted in changes to the insertion techniques. These changes are due to the overall context that acupuncture practice is embedded in, and are linked to the specific history of Taiwan.