OBJECTIVES: To observe the effect of acupuncture on the oxeiptosis Kelch-like ECH-associated protein 1 (KEAP1)/phosphoglycerate mutase 5 (PGAM5)/mitochondrial apoptosis-inducing factor 1 (AIFM1) signaling pathway in rats with diminished ovarian reserve (DOR), so as to explore the possible mechanisms by which acupuncture improves ovarian reserve function in DOR rats. METHODS: Female SD rats were randomly divided into the control group, model group, and acupuncture group, with 6 rats in each group. The DOR model was established by one-time intraperitoneal injection of 75 mg/kg cyclophosphamide. After modeling, the acupuncture group received acupuncture at "Guanyuan" (CV4), "Zhongji" (CV3), "Qihai" (CV6), and bilateral "Sanyinjiao" (SP6), "Zigong" (EX-CA1) acupoints for 20 min each time, every other day, for a total of 15 sessions. During the experiment, the estrous cycles of the rats were observed and recorded daily. After the intervention, the body mass and ovarian mass were measured, and the ovarian index was calculated. Serum contents of estradiol (E RESULTS: Compared with the control group, the model group exhibited irregular estrous cycles, increased contents of FSH and LH ( CONCLUSIONS: Acupuncture can improve ovarian reserve function, and its mechanism may be related to the inhibition of the oxeiptosis pathway.