OBJECTIVE: To propose an automatic acupuncture robot system for performing acupuncture operations. METHODS: The acupuncture robot system consists of three components: automatic acupoint localization, acupuncture manipulations, and RESULTS: Through repeated experiments for eight acupoints, the acupuncture robot achieved a positioning error within 3.3 mm, which is within the allowable range of needle extraction and acupoint insertion. During needle insertion, the robot arm followed the prescribed trajectory with a mean deviation distance of 0.02 mm and a deviation angle of less than 0.15°. The results of the lifting thrusting operation in the Xingzhen process show that the mean acupuncture depth error of the designed acupuncture robot is approximately 2 mm, which is within the recommended depth range for the Xingzhen operation. In addition, the average detection accuracy of the CONCLUSION: The proposed acupuncture robot system streamlines the acupuncture process, increases efficiency, and reduces practitioner fatigue, while also allowing for the quantification of acupuncture manipulations and evaluation of therapeutic effects. The development of an acupuncture robot system has the potential to revolutionize low back pain treatment and improve patient outcomes.