Abstract: Anti-tumor drug-related oral mucositis (ADOM) is a dose-limiting adverse reaction in tumor treatment, which is characterized by mucosal ulcer and pain. In severe cases, it affects the quality of life and treatment process of patients. The pathogenesis of ADOM varies with the type of anti-tumor drugs, involving the interaction of various mechanisms such as inflammatory factor imbalance, oral flora imbalance, and immune response imbalance. In the prevention and treatment of traditional Chinese medicine, traditional Chinese medicine extract/single drug and compound can effectively improve the mucosal condition of ADOM patients through multi-target mechanisms such as anti-inflammation, anti-oxidation and immune regulation. Based on a systematic review of the modern pathogenesis of ADOM, this paper summarizes the research progress of traditional Chinese medicine in the prevention and treatment of ADOM from the targeted signaling pathways of Chinese herbal monomers, extracts and compound prescriptions, aiming to provide theoretical basis and therapeutic strategies for the clinical prevention and treatment of ADOM.