The prolonged post-operative pain often associated with myofascial trigger point which also contribute to reduction of range of motion (ROM). State Boards of Physical Therapy defined dry needling as an ‘intramuscular procedure involving the isolated treatment of myofascial (muscle) trigger point. The purpose of this systematic review was to determine if the addition dry needling to a rehabilitation protocol is more effective in reducing pain levels and improving prognosis of the post-operative patient of extremity when compared to a rehabilitation protocol alone based on current study evidence. Three electronic databases were used; PubMed, Cochrane Library, and ProQuest. Studies included were randomized clinical studies that written in English and published from last 10 years (2014). Post operative patient, any type of extremity surgery, any sex, any age, getting rehabilitation procedure with or without dry needling. Data collection was conducted using standard agreed form by two independent reviewers. The risk of bias and quality were assessed using Revised Cochrane risk-of-bias tool for randomized trials (RoB2). Three studies were selected for this systematic review, include total of 103 patients. Two of selected studies had some concern, and one study were deemed to have high risk of bias. Overall both group shown reduced pain levels, and improvement of other criteria (ROM, functionality, activity of daily living) over time, with dry needling on top of rehabilitation protocol have advantage in prognosis of the patient. Looking at the data collected, although there is still a lot of bias in this review. Even though there was no evidence of superiority in reducing the pain level, we support dry needling as the adjuvant therapy for post-operative pain (extremity surgery) alongside with physical therapy rehabilitation protocol because the procedure has better prognosis than physical therapy rehabilitation protocol alone (ROM, functionality, activity of daily living).