Apoptosis is programmed cell death that can be maladaptive when not properly regulated, especially when it occurs in the hippocampus. The exact mechanisms for apoptotic malfunctioning are yet to be fully understood. Acupuncture has seen a recent rise in western medicine and is used to treat various blood flow related conditions such as strokes or ischemia. The exact mechanisms for acupuncture are also still unknown. This systematic review evaluated the potential for acupuncture to help mediate hippocampal apoptosis. A search was conducted through PubMed, Scopus, and WebofScience using the keywords “hippocampus,” “apoptosis,” and “acupuncture” and found 37 qualified articles from January 2009 to March 2019. All of the articles supported acupuncture decreasing the incidence of hippocampal apoptosis. The most frequently suggested mechanism was decreased BAX expression and increased BCL-2 expression, often in the CA1 region of the hippocampus; although, it was only seen in about 1/3 of the articles. While no exact mechanism is understood within current literature, acupuncture does indeed have the potential to mediate hippocampal apoptosis.