[Objectives] The aim of this study was to investigate the effect of electroacupuncture on infarct size in cerebral ischemic stroke. [Methods] A systematic electronic search was conducted up to June 1, 2024. TTC staining was used to evaluate the infarct size. Standard mean differences (SMD) with a 95% confidence interval (CI) were calculated to assess the two intervention methods. The heterogeneity of the included studies was also tested. Two analyses with subgroups were planned: intervention start time (before MCAO versus after MCAO), waveform (continuous wave versus disperse wave). [Results] Forty-one studies with a total of 502 rats or mice were included in this review. The pooled analysis of these trials showed a significant positive effect of electroacupuncture on the infarct size (SMD=-2.65, P<0.000 1, Z=12.55). Subgroup analysis results indicated that electroacupuncture intervention before MCAO surgery (16 studies, SMD=-2.73, P<0.000 01, Z=10.60) could more significantly reduce infarct size than that after MCAO surgery (25 studies, SMD=-2.61, P<0.000 01, Z=8.20). Additionally, disperse waves (31 studies, SMD=-2.46, P<0.000 01, Z=11.08) were more effective in reducing infarct area than continuous waves (10 studies, SMD=-3.38, P<0.000 01, Z=6.12). [Conclusions] This review provided sufficient evidence that electroacupuncture before MCAO surgery with disperse waves was more effective in reducing infarct area than after MCAO surgery and continuous waves.