We searched the literature using 18 databases from their inception to February 10, 2010, without language restrictions. We included randomized clinical trials (RCTs), in which human patients with UC were treated with moxibustion. Studies were included if they were placebo-controlled or controlled against a drug therapy or no treatment group. The methodological quality of all RCTs was assessed using the Cochrane risk of bias.In total, five RCTs were included. All were of low methodological quality. They compared the effects of moxibustion with conventional drug therapy. Three tested moxibustion against sulfasalazine and two against sulfasalazine plus other drugs. A meta-analysis of five RCTs showed favorable effects of moxibustion on the response rate compared to conventional drug therapy (n = 407; risk ratio = 1.24, 95% CI = 1.11 to 1.38; P < 0.0001; heterogeneity: I2 = 16%).Current evidence is insufficient to show that moxibustion is an effective treatment of UC. Most of included trials had high risk of bias. More rigorous studies seem warranted.Ulcerative colitis (UC) is a common, chronic idiopathic inflammatory bowel disease (IBD) . Patients typically present with bloody diarrhea, passage of pus, mucus, or both, and abdominal cramping during bowel movements . UC often requires lifelong medication, but poor adherence to medication has been an important barrier to successful management. Relapse rates are high, and the risk of colorectal cancer has increased [3,4].Complementary and alternative medicine (CAM) is increasingly used for treatment of IBD , and acupuncture and moxibustion are particularly popular options. Moxibustion is a traditional Oriental medicine that uses the heat generated by burning herbal preparations containing Artemisia vulgaris to stimulate acupuncture points. Direct moxibustion is applied directly to the skin surface at an area around an acupuncture point, whereas indirect moxibustion is performed with some insulating materials (e.g.