Osteoarthritis (OA) is a kind of joint diseases characterized by fibrosis, ulceration, and loss of articular cartilage and articular surrounding tissues caused by various factors, the main symptoms of OA include joint pain, joint stiffness, and loss of joint function, and OA has the higher prevalence rate and has been listed as one of the four major disabling diseases, seriously affecting people's lives and health. Traditional Chinese medicine (TCM) is a comprehensive science based on the theory of Yin Yang (one TCM theory, the material world is believed to be nurtured, developed, and changed under the influence of Yin and Yang) and Five Elements (The five most basic substances - wood, fire, earth, metal, and water - are considered indispensable elements that make up the world), based on TCM theory and practical experience it can play the important role in prevention, diagnosis, treatment, rehabilitation, and health care in OA, exhibit the great application potential for OA treatment. In this review, we have summarized the recent research progress in the application of TCM in OA, including an analysis of underlying mechanisms, application limitations, and potential solutions, found that the material basis and targets of the therapeutic component of TCM, the quality control and the mechanism of TCM application in OA are not very clear, which may become the application limitation of TCM in OA. We hope that this review will offer valuable insights to researchers in the field.