Abstract: Disease burden caused by major depression ranks on the top. However， current mainstream western medicine with monoamine-based antidepressants has remarkable limitations， in contrast to the unique efficacy of traditional Chinese medicine (TCM). Here we reviewed the recent progress in TCM treatment of the disorder， including clinical outcomes， rapid onset of antidepressant response， treatment based on pattern identification of major depression， novel neuropharmacological mechanisms， and antidepressant effects of acupuncture. The clinical and basic research all supported the antidepressant efficacy of TCM， and some with rapid onset. It is suggested that the future research should address the issues of the standardization of treatment based on pattern identification， disease prevention and treatment outcomes using large population， and emphasize the basic research employing systems biology and multidisciplinary collaborative approaches.