Abstract: Colorectal cancer (CRC), a prevalent and deadly digestive malignancy, primarily causes death through recurrence and metastasis. Current treatments include surgery, radiotherapy, chemotherapy, and immunotherapy, but they have significant side effects and high recurrence rates. Research shows traditional Chinese medicine (TCM) can alleviate symptoms, reduce adverse reactions, enhance quality of life, prevent recurrence and metastasis post-surgery, and improve survival rates. This review explores TCM's theoretical framework, advantages in CRC management, and potential in modulating intestinal flora for CRC prevention and treatment.