Abstract: Nonalcoholic fatty liver disease (NAFLD) is a metabolic syndrome that has become a public health problem of general concern. Nonalcoholic steatohepatitis (NASH) is a progressive NAFLD lesion resulting from the interaction of multiple risk factors with multiorgan involvement. Due to the complex underlying pathophysiologic mechanisms that contribute to the development and progression of NASH, there are no approved drugs to control the progression of the disease. Based on traditional Chinese medicine(TCM) theory, NAFLD belongs to the category of "Ganpi", and was divided into 4 syndrom types: liver stagnation and spleen deficiency, internal obstruction of phlegm and dampness, obstruction of dampness and heat, and interaction of phlegm and blood stasis. Chinese medicine can effectively intervene and treat different clinical types of NASH with its unique theoretical system and treatment strategy. With the continuous development of modern pharmacology and molecular biology, more and more studies have shown that TCM compound formula and active monomers can improve NASH through various mechanisms, which promotes the application of TCM. This review focuses on the mechanisms related to the improvement of NASH by TCM from the perspectives of compound formula and active monomers, in order to provide a theoretical and experimental research basis for the rational and effective treatment of NASH.