Objective To systematically evaluate the effectiveness of acupoint stimulation versus antiemetic in the prevention and treatment of postoperative nausea and vomiting (PONV). Methods PubMed, Embase, The Cochrane Library, CBM, Ovid, VIP, WangFang Data and CNKI databases were searched to collect randomized controlled trial (RCT) about the prevention and treatment of PONV through acupoint stimulation from January 1, 2000 to May 1, 2019. Two reviewers independently screened the literature, extracted data and assessed the risk of bias of included studies. Then, meta‑analysis was performed using RevMan 5.3 software. Results A total of 25 RCT involving 3 138 patients were included. The results showed no statistical differences in the incidence of postoperative nausea, early nausea, late nausea, postoperative vomiting, late vomiting and the use of remedial antiemetics between the acupoint stimulation group and the antiemetic group ［odds ratio (OR)=0.92, 95% confidence interval (CI) (0.64, 1.32), P=0.65］, ［OR=0.72, 95%CI (0.50, 1.03), P=0.07］, ［OR=0.86, 95%CI (0.51, 1.45), P=0.57］, ［OR=0.89, 95%CI (0.65, 1.22), P=0.47］, ［OR=0.96, 95%CI (0.64, 1.44), P=0.85］ and ［OR=0.71, 95%CI (0.42,1.19), P=0.19］. However, the incidence of early vomiting in the acupoint stimulation group was lower than that in the antiemetic group ［OR=0.64, 95%CI (0.45, 0.90), P=0.01］. There was no significant difference in the incidence of postoperative nausea, postoperative early nausea, late nausea, postoperative vomiting and late vomiting between the pericardium 6 (P6) stimulation group and the antiemetic group ［OR=0.91, 95%CI (0.61,1.36), P=0.66］, ［OR=0.72, 95%CI (0.50,1.03), P=0.07］, ［OR=0.86, 95%CI (0.51, 1.45), P=0.57］, ［OR=0.76, 95%CI (0.51, 1.13), P=0.18］ and ［OR=0.93, 95%CI (0.59, 1.46), P=0.75］. The incidence of postoperative early vomiting in the P6 stimulation group was lower than that in the antiemetic group ［OR=0.60, 95%CI (0.40, 0.90), P=0.01］. The incidence of postoperative nausea and vomiting in the acupoint stimulation combined with antiemetic group was lower than that in the antiemetic group ［OR=2.13, 95%CI (1.31, 3.46), P=0.002］ and ［OR=3.93, 95%CI (2.06, 7.48), P<0.001］. Conclusions Acupoint stimulation can be used to prevent and treat PONV, and its effectiveness is similar to antiemetics with better effects on postoperative early vomiting. Acupoint stimulation combined with antiemetic can enhance the effect on preventing and treating PONV. Due to limits in the quantity and quality of the included studies, the above conclusions need to be verified by more high‑quality studies.