Abstract: Pelvic inflammatory disease (PID) is a clinical syndrome caused by infection of the upper female reproductive tract. If PID persists without cure, it may develop into sequelae of pelvic inflammatory disease (SPID). SPID often leads to chronic pelvic pain, ectopic pregnancy, infertility and other sequelae, which greatly endanger the physical and mental health and quality of life of women. Research has confirmed that progressive fibrosis is the common pathological basis and core mechanism of various sequelae of SPID. This process is mediated by multiple signaling pathways in concert, which ultimately drive the occurrence and progression of pelvic tissue fibrosis by promoting excessive activation of inflammatory factors, oxidative stress, and pelvic microcirculation disorders. Currently, modern medicine faces challenges of insufficient anti-fibrotic efficacy and high recurrence rates in the treatment of SPID. Therefore, the multi-target and holistic regulatory advantages of traditional Chinese medicine in intervening in the key links of SPID fibrosis have attracted increasing attention. This article aims to systematically construct a signaling pathway regulatory network centered on fibrosis in SPID, deeply explain the molecular mechanisms of core, synergistic, and potential pathways promoting fibrosis; and focus on reviewing how traditional Chinese medicine exerts anti-fibrotic effects by multi-target intervention in this network, with the expectation of providing a solid theoretical basis for the development of new targeted fibrosis treatment strategies combining traditional Chinese and Western medicine.