Abstract: Respiratory syncytial virus (RSV) infection is a major respiratory disease threatening the health of infants and immunocompromised populations worldwide, with no specific therapeutic drugs available. Traditional Chinese medicine (TCM) has shown unique advantages of multi-target and multi-pathway in the prevention and treatment of RSV infection, and its mechanism is closely related to the regulation of cellular signaling pathways. This article systematically reviews the research progress of TCM including monomer components and compound prescriptions in intervening RSV infection through nuclear factor-κB (NF-κB), Janus kinase/signal transducer and activator of transcription (JAK/STAT), phosphatidylinositol 3-kinase/protein kinase B (PI3K/Akt), mitogen-activated protein kinase (MAPK), nuclear factor E2-related factor 2/heme oxygenase-1 (Nrf2/HO-1) and other signaling pathways. Current research still has problems such as insufficient analysis of pathway synergy mechanisms, unclear material basis of compounds, and single technical means. Future studies should focus on cross-talk of multiple pathways, identification of active component groups of TCM, and research on "syndrome-type-pathway" association, combined with cutting-edge technologies such as network pharmacology and organoid models, so as to provide a scientific basis for the mechanism and clinical transformation of TCM against RSV infection.