Background: The burning mouth syndrome (BMS) is a chronic orofacial disease characterized by symptoms of burning in the oral cavity without being able to detect anatomical lesions. Acupuncture has been suggested as a possible treatment of BMS. This study aimed to examine this alternative form of therapy in a blinded fashion. Methods: Forty patients with primary BMS were treated with either verum or sham acupuncture in a series of 10 treatments. Questionnaires regarding pain, clinical symptoms and current sensitivity were completed before and after the acupuncture treatments. In addition, tests for olfactory and gustatory sensitivity were performed as well as measurements of salivary production. Results: The results indicate a significantly reduced pain intensity in the verum acupuncture group, which patients noted particularly in the evening. Furthermore, verum acupuncture was associated with an increase in the amount of saliva. No significant changes regarding olfactory and gustatory functions were noted in conjunction in either treatment group. Conclusion: This study shows that acupuncture can be an alternative therapy option for patients with primary BMS.