• An accelerated and intensive scalp acupuncture treatment is proven to be effective to improve the depressive symptoms and subjective quality of life among patients with depression. • Acupuncture is a neuromodulation intervention protocol that is well accepted by a multiethnic South-east Asia population. • The value of acupuncture as an augmentation therapy for in-hospital patients with primary depressive symptoms was examined via a randomized, pragmatic, controlled trial. To test the effectiveness of an accelerated acupuncture treatment as an augmentation therapy for patients with primary diagnosis of major depressive symptoms. Recruited patients were 1:1 randomly assigned to receive either treatment-as-usual (wait-list controlled group) or with additional acupuncture intervention (treatment group). The acupuncture treatment includes daily scalp acupuncture with manual stimulation for a total of 10 sessions conducted within 2-3 weeks. Blinded raters assessed patients’ depressive symptoms and quality of life at baseline (pre-treatment), immediately after treatment, 2 weeks, and 3 months post-treatment. A total of 84 patients with 59 (70.2%) Chinese, 17 (20.2%) Malay and 4 (4.8%) Indians participated in this trial. There is an overall improvement of depressive symptoms score assessed by Montgomery–Åsberg Depression Rating Scale (MADRS) and Quick Inventory of Depressive Symptomatology- Self report 16 items (QIDS-SR16), and an improvement of subjective Quality of life assessed by EQ5D Visual Analogue Score (VAS) and Utility Score (US) from pre-treatment to 3 months post-treatment for patients in both treatment groups and control group. In addition, compared to patients in control group, acupuncture induced an overall significantly better QIDS-SR16 (effect size η 2 = 0.15, p =0.025) and better EQ-5D Visual Analogue Scale score ( η 2 = 0.20, p =0.005). Acupuncture induced an accumulated and delayed antidepressant treatment effect for patients with depression. Our study informed the potential of an accelerated acupuncture treatment as an augmentation antidepressant therapy within a multiethnic South-east Asian population.