To the editor,I read with interest the recent report on “filiform needle acupuncture for poststroke depression” (Zhang et al., 2014). Zhang et al. (2014) performed a meta-analysis and concluded that “early filiform needle acupuncture for poststroke depression can perfectly control depression.” In fact, the included meta-analysis might support the clinical effectiveness of filariform needle acupuncture for poststroke depression. However, there are several concerns. First, the hospital infection due to acupuncture manipulation with filiform is a big topic to be addressed. As Gang et al. (2012) noted, “aseptic technic principles aren’t strictly followed; disinfection and isolation systems are unsound; sanitary condition of hand of medical staff is unsatisfied.” In addition, some serious penetrating injury such as pneumothorax is also possible (Zhao and Zhang, 2009). Second, there are many local Chinese publications in meta-analysis. To assess the subjective score reported by the patients, there might be some language barriers to be kept in interpretation.