Introduction The study aimed to validate the effectiveness of Wrist and Ankle Acupuncture (WAA) in attenuating moderate to severe postoperative pain following Functional Endoscopic Sinus Surgery (FESS). Methods Participants were randomly allocated into a treatment group ( n = 57) and a control group ( n = 58). The treatment group underwent WAA treatment, while the control group received sham acupuncture treatment. The Numeric Rating Scale (NRS) was employed to assess postoperative pain. The sleep efficiency, the amount of rescue medication, and the adverse events were also evaluated for both groups. Results A significant immediate reduction in NRS scores was observed in the treatment group ( p < .01). At 2, 4, 8, 22, and 24 h after first treatment, pain intensity decreased in the WAA group compared with the control group ( p < .01). Moreover, the WAA group demonstrated superior sleep efficiency relative to the control group on the night after surgery ( p < .01). And the mean number of rescue tablets used on the WAA group was obviously lower than the control group ( p < .01). There were no serious adverse events in both groups, and all adverse events completely disappeared within 3 days. Conclusion WAA effectively alleviated postoperative discomfort associated with nasal packing subsequent to FESS and enhanced sleep quality during the postoperative night. The anatomical superficiality of the acupuncture points employed reduces the risk of adverse events while yielding effective analgesic results, thus validating its suitability for clinical application.