This study retrieved literature on fire needle therapy for bulbar palsy from the China National Knowledge Infrastructure (CNKI), VIP Chinese Science and Technology Journals Database, Wanfang Data Knowledge Service Platform, SinoMed, PubMed, Cochrane Library, Web of Science, and EBSCO Medline, spanning from the inception of the databases to March 1, 2025. The selected literature was categorized and analyzed based on acupuncture point selection, treatment methods, and therapeutic mechanisms. A total of 19 Chinese articles and 3 English articles were included. The five most frequently used acupoints were Zusanli, Lianquan, Fengchi, Quchi and Hegu. Extraordinary points were predominantly selected based on local symptoms. This study summarized common acupoints to provide guidance for fire needle therapy in bulbar palsy, highlighting its clinical value and offering new treatment perspectives for the condition. However, significant gaps remain in research on individualized treatment under syndrome differentiation and mechanism studies, warranting further investigation.