In order to elucidate the application value and implementation pathway of target trial emulation (TTE) in clinical research of acupuncture and moxibustion

this article reviews the key methodological components of TTE

including data readiness assessment

target trial protocol specification

treatment strategy allocation

alignment of time zero (T0)

definition of outcomes and follow-up

estimation-based target choice

control of confounding and censoring

diagnostic and sensitivity analyses

and reporting standards. Key operational points are also summarized based on real-world study (RWS) cases of acupuncture and moxibustion. Using a hypothetical randomized controlled trial (RCT) as the reference

TTE translates a research question into an executable observational study protocol

thereby helping to address pre-control design bias

enhance research transparency and strengthen causal interpretation. The application of TTE in acupuncture- moxibustion research should rely on standardized case registration system and emphasize the structured collection of real-world data. Findings from TTE studies may serve as an important complement to RCT evidence

but they remain the limitations such as data quality

unmeasured confounding factors

and the difficulty in simulating sham-acupuncture controls. Hence

these findings should be interpreted and applied with caution.