Objectives and Methods : The aim of this study was to investigate twirling and supplementation and draining by analyzing ancient acupuncture literature and modern research papers, and to discuss the quantitative standards for the procedure. Results : Twirling supplementation and draining techniques were first described in Huang do neijing, after which they were recorded in various other ancient acupuncture texts. Not only were these techniques used in the active treatment of patient historically, but they also form the foundations of modern-day acupuncture treatment. Twirling supplementation and draining techniques described in ancient literatures can be divided into Yin and Yang. Examples of Yang characteristics include Up, Male, Morning, Hands, the governor vessel, Outside, and Left. The left rotation technique is a reinforcing method performed by moving the thumb forward while rotating the needle. Examples of Yin characteristics include Down, Female, Afternoon, Foot, the conception vessel(CV), Inside, and Right. The right rotation technique is a reducing method performed by moving the thumb backward while rotating the needle. Twirling supplementation and draining has been divided for four ways by classical literature and research that worked before. the direction of acupuncture, the stimulus-quantity of acupuncture, the performance of doctor(the uses of both hands, left and right hand) and the feeling of patient. Conclusions : Therefore, continuous research is required to implement Twirling supplementation and draining in a consistent manner. In addition, more active clinical trials using the techniques are necessary as well.