Background: This study assessed effects of acupuncture as an add-on to conventional antihypertensive managements such as medication or lifestyle modification for hypertensive or pre-hypertensive subjects.Methods: A randomized, double-blind, placebo-controlled trial was conducted at Kyung Hee University Hospital. Forty-one hypertensive or pre-hypertensive (systolic BP≥120 mmHg or diastolic BP≥80 mmHg) volunteers were recruited and randomly assigned into real or sham acupuncture groups. The hypertensive subjects on antihypertensive medication continued their medication. Acupuncture point prescriptions were partially individualized, based on the Saam acupuncture theory. Park's sham needle method was adopted for the sham procedure. Measurements were performed at baseline, weeks 4 and 8. BP, scales of overall health and pain, and anticipation or satisfaction for the treatments, were recorded.Results: Thirty subjects completed the intervention, all of whom were on antihypertensive medication. The sham acupuncture group showed no significant change in mean BP, while the real acupuncture group showed a significant (p<0.01) decrease in mean BP after 8 weeks of intervention from 136.8/83.7 to 122.1/76.8 mmHg. Other factors showed no difference between the groups throughout the study.Conclusion: Acupuncture seems to offer an additional benefit to the treatment of hypertensive patients.