The pathological development of chronic obstructive pulmonary disease (COPD) is closely related to the imbalance of immune-inflammatory homeostasis, mainly involving the dysregulation of T helper (Th) cell subset homeostasis, imbalance of inflammatory cell networks, cytokine storm, regulation of inflammatory signaling pathways, activation of the cholinergic anti-inflammatory pathway, autophagy-mediated inflammatory response, and regulation of other inflammatory pathways. Through the multidimensional regulatory network of “acupoint-nerve-immunity”, acupuncture can simultaneously act on multiple key nodes such as the cholinergic anti-inflammatory pathway, kinase-mediated inflammatory response pathways, to remodel Th17/regulatory T lymphocyte (Treg) balance, and regulation of macrophage classical activation (M1)/alternative activation (M2) polarization, demonstrating superior homeostasis-regulating characteristics. This article systematically reviews the latest research progress on acupuncture in the multi-target synergistic regulation of immune-inflammatory homeostasis in COPD, aiming to provide evidence for the integrated treatment of COPD.