Abstract: Cutaneous adverse reactions to antitumor therapy (CARAT) are critical issues affecting patients’ quality of life, treatment adherence, and prognosis. This article systematically reviews the current status of research on the prevention and treatment of CARAT using Traditional Chinese Medicine (TCM), covering aspects such as the understanding of TCM pathogenesis, clinical research evidence, and mechanisms of action. It details TCM syndrome types and stage-based treatment protocols for major CARAT categories, including hand-foot skin reactions, acneiform eruptions, and radiation-induced skin injuries. However, significant bottlenecks persist, including a lack of unified theoretical frameworks, low-quality clinical evidence, and lagging innovation in TCM preparations. To address these challenges, the article proposes strategies such as unifying TCM disease nomenclature and syndrome differentiation standards, conducting large-scale, high-quality clinical validation, establishing standardized animal models, developing novel TCM dosage forms, and building a comprehensive system for the integrated TCM-Western medicine management of CARAT throughout the treatment process. These measures aim to provide a reference for basic research and clinical translation regarding the prevention and treatment of CARAT with TCM.