Abstract: Infectious diseases of the respiratory system are very common in clinical practice, among which pneumonia caused by influenza virus infection is characterized by high morbidity and mortality. Current clinical treatments for respiratory viral infections still face challenges such as drug resistance and poor efficacy. Necroptosis, a form of programmed cell death, is closely associated with the progression of respiratory viral infections. Traditional Chinese medicine modulating necroptosis has demonstrated beneficial therapeutic effects in these diseases. This paper introduces the concept and mechanisms of necroptosis, reviews recent research on the relationship between necroptosis and respiratory virus infections diseases, and summarizes the therapeutic effects of traditional Chinese medicine in regulating necroptosis to intervene in these diseases, aiming to provide insights for the development and clinical application of therapeutic agents for respiratory viral infections.