This study aims to give an overview of systematic reviews on the efficacy and safety of puncture and bloodletting therapy for gout, so as to provide evidence-based evidence for the clinical decision-making application of this therapy. CNKI, Wanfang, VIP, SinoMed, PubMed, EMbase, Cochrane Library, and Web of Science were searched by computer until December 1, 2024. After the two researchers screened the literature and extracted the data independently, the methodology quality and reporting quality of included systematic reviews were assessed via AMSTAR2 and version 2020 of PRISMA, and the evidence level of included systematic reviews was evaluated by GRADE. A total of nine systematic reviews were included, covering 70 non-repeated randomized controlled trials(RCTs), among which 22 were simple bloodletting therapy and 48 were combined bloodletting therapy. The patient conditions included all cases of gouty arthritis. The total number of patients included was 3 937, with 2 007 in the intervention group and 1 930 in the control group. In terms of efficacy, all the included systematic reviews indicated that bloodletting therapy could effectively treat gout, and it was also effective in reducing blood uric acid levels and relieving pain. Five systematic reviews concluded that both simple bloodletting therapy and combined bloodletting therapy had good efficacy. Two reviews indicated that fire needle therapy had good efficacy. One review indicated that needle knife therapy had good efficacy, and one review indicated that only combined bloodletting therapy had good efficacy. In terms of safety, eight systematic reviews showed that bloodletting therapy was relatively safe. The AMSTAR2 evaluation results showed that only five items were complete reports. Two items were severely lacking, and five key items had different deficiencies. The proportion of PRISMA items with a reporting completeness of more than 50% is 59.25%. The PRISMA scores of each systematic review ranged from 12.5 to 20.5. The GRADE evaluation results showed that the overall evidence quality was low, and the evidence quality of 45 outcome indicators was of low to very low quality. The corrected covered area(CCA) was 11.43%, indicating that the RCT studies included in the systematic reviews might have a high degree of overlap. Therefore, the puncture and bloodletting therapy for gout has certain therapeutic effects and is relatively safe. However, there are some problems in the systematic review, such as the lack of detailed reporting of the process, conflicts of interest, and publication bias. In the future, when making systematic reviews, it is necessary to focus on the registration of the plan and make the process of evidence-based evidence production transparent. It is recommended to further refer to tools such as PRISMA, AMSTAR2, and GRADE to improve the quality of evidence-based evidence, so as to provide more reliable evidence-based evidence for future clinical decision-making.