Objectives : The aim of this study was to report the effects of acupuncture on the patients with severe acute musculoskeletal pain transferred from emergency department(ED). Methods : Three patients were transferred from ED of western medicine, and treated with Korean medicine treatments composed of acupuncture mainly and cupping, herbal steaming, and herbal decoction additionally. Results : All patients showed pain-reduction and relaxation both physically and mentally immediately after the first acupuncture treatment. In cases 1 and 2, the pain numerical rating scale(NRS) decreased after the day of admission from 8 to 4 and 10 to 2, respectively. In case 3, pain NRS also gradually decreased from 8 to 4 after three days. Conclusion : Acupuncture was effective for immediate pain reduction in patients with severe acute musculoskeletal pain transferred form ED. Further studies are warranted to confirm the immediate pain-reduction effect of acupuncture on acute musculoskeletal patients visiting or transferred from ED.