Abstract: Prevalence of ulcerative colitis (UC) accompanied by anxiety and depression continues to rise, with mechanisms closely linked to brain-gut-microbiota axis dysregulation and inflammatory responses. Traditional Chinese medicine (TCM) theory posits that the core pathogenesis lies in "liver depression and spleen deficiency". TCM treatment demonstrates potential in alleviating UC with anxiety and depression through its characteristic advantages of "holistic regulation and mind-body co-treatment". This article elucidates the pathogenesis from both Western medicine and TCM perspectives and reviews research progress on TCM interventions, aiming to provide a theoretical basis for precise UC diagnosis/treatment and multidisciplinary intervention strategies.