Ear acupressure pills, as an external treatment method in traditional Chinese medicine, are increasingly widely used in the prevention and control of myopia in children and adolescents. This article provides a systematic review of the mechanism of action, clinical research protocol characteristics, efficacy evaluation, and influencing factors. The mechanism involves the regulation of meridians, Qi and blood, improvement of ciliary muscle function, and neuro humoral regulation; Preliminary consensus has been reached on the selection of main acupoints, treatment frequency, and combination behavior/Western medicine intervention in the clinical plan; The therapeutic effect shows a gradient feature of pseudo superiority over low and low superiority over moderate, with better results observed in younger age and early onset of myopia. The existing research still has limitations, such as low methodological quality and inconsistent outcome indicators. In the future, large-scale randomized controlled trials should be conducted, with axial length as the core indicator, and a standardized protocol should be established.