Background and aims Promoting gastrointestinal function recovery is one of the key aspects of enhanced recovery after surgery (ERAS) for colorectal cancer (CRC). Many ancient Chinese medical texts suggest that acupuncture at four acupoints—Zusanli, Shangjuxu, Sanyinjiao, and Neiguan—helps promote gastrointestinal peristalsis. However, there is currently no systematic study on multi-point acupuncture to promote postoperative gastrointestinal function recovery in CRC patients. Therefore, this study was conducted to evaluate the clinical efficacy of multi-point acupuncture in promoting gastrointestinal function recovery in CRC patients through a prospective study to provide new options for implementing ERAS in CRC patients in clinical practice.Methods Using a prospective, randomized, controlled design, a total of 100 eligible patients who underwent laparoscopic CRC radical surgery at the Department of Gastrointestinal Surgery, Third Xiangya Hospital of Central South University, between January 2021 and February 2022, were randomly divided into an observation group and a control group, with 50 patients in each group. Both groups underwent the same ERAS protocols and radical surgery during the perioperative period. The observation group received acupuncture treatment from the day of surgery to the third postoperative day, once per day, while the control group did not receive acupuncture. Primary outcomes included the time to bowel sound recovery, time to first flatus, and time to first defecation. Secondary outcomes included abdominal pain scores, incidence of bloating, nausea, vomiting, white blood cell count, neutrophil percentage, C-reactive protein, hemoglobin, serum albumin, blood potassium levels, postoperative hospital stay, and incidence of postoperative complications.Results A total of 96 patients completed the study, with 48 in each group. There were no statistically significant differences in baseline characteristics such as age, gender, or surgery time between the two groups (all P>0.05). Compared with the control group, the observation group had a significantly shorter time for bowel sound recovery, first flatus, first defecation, and postoperative hospital stay (all P<0.05). Additionally, the observation group showed reduced abdominal pain scores on postoperative day (POD) 2 and 3, a lower incidence of bloating on POD 1 and 2, and a reduced incidence of nausea and vomiting on POD 3 (all P<0.05). There were no statistically significant differences in the remaining comparisons between the two groups (all P>0.05).Conclusion Multi-point acupuncture treatment can promote the recovery of gastrointestinal function in patients undergoing minimally invasive CRC surgery without increasing postoperative complications, and it is recommended for integration into routine ERAS protocols.