Abstract: Non-coding RNA (ncRNA) plays a key regulatory role in development and disease progression, particularly in tumors. Traditional Chinese medicine, as a valuable medicinal resource, holds significant promise for anti-tumor therapy through the modulation of ncRNA. This review summarizes recent research progress and explores the mechanisms by which active ingredients in traditional Chinese medicine exert anti-tumor effects via ncRNA regulation, aiming to provide a theoretical basis for the development of novel anti-tumor drugs.