Objectives: This study aimed to evaluate the clinical efficacy of local lipolysis pharmacopuncture LIPOSA through a retrospective chart review of patients seeking obesity treatment at Korean medical institutions. Methods: A retrospective multi-center study was conducted by analyzing medical records of patients who visited six Korean medical institutions for obesity treatment between January 2023 and April 2024. A total of 117 patients were included: 62 patients in the LIPOSA group (herbal medicine treatment with LIPOSA pharmacopuncture) and 55 patients in the control group (herbal medicine treatment only). Changes in body composition including weight, body mass index (BMI), skeletal muscle mass, body fat mass, and body fat percentage were analyzed. Results: Both groups showed improvements in obesity-related clinical indicators after treatment. The LIPOSA group demonstrated significantly greater reductions in body fat mass (-4.20 ± 4.08 kg vs -2.64 ± 1.96 kg, p = 0.0088) and body fat percentage (-3.20 ± 3.24% vs -1.88 ± 1.86%, p = 0.079) compared to the control group. Additionally, the LIPOSA group showed better preservation of skeletal muscle mass during treatment. Conclusion: The study demonstrates that LIPOSA pharmacopuncture combined with herbal medicine treatment is more effective in reducing body fat while preserving muscle mass compared to herbal medicine treatment alone, suggesting its potential as an effective treatment for localized obesity.