The use of filiform needles, a tool central to acupuncture, has become a fierce battleground, particularly with physical therapists practicing "dry needling." This article examines this scope-of-practice conflict through the lens of two starkly different state outcomes. In California, a coordinated campaign by acupuncture associations successfully defeated a bill that would have authorized physical therapists to use these needles, marking a significant legislative win. However, the author cautions that this victory leaves California as one of only three states holding this line. In contrast, North Carolina offers a sobering lesson. There, the Acupuncture Licensing Board’s attempts to stop dry needling via cease-and-desist letters resulted in a federal antitrust lawsuit, a court ruling against them, and a hefty settlement. The key takeaway is that aggressive border-policing can be legally perilous and ineffective. Instead of fighting over terminology, the article urges the acupuncture profession to shift its argument to competence and patient safety. The most compelling case lies in the vast disparity in training—thousands of hours for an acupuncturist versus a weekend course for some physical therapists. Advocating for rigorous, standardized training for anyone wielding a needle is the profession’s strongest and most defensible position.