Abstract: Epigenetics occupies an important position in the clinical treatment and prevention of cancer. Epigenetic changes such as DNA methylation(DNMT), histone modification, non-coding RNA (ncRNA), and chromatin structural remodeling, and chromatin remodeling are based on gene regulation beyond the DNA base sequence and do not affect the DNA base sequence. Epigenetic changes are involved in a variety of biological processes of clinical malignant tumors by regulating the transcription of tumor suppressor or cancer-promoting genes or the expression of related genes, silencing or DNA replication and repair, telomere regulation, centromeric stability, chromosome separation and other processes, and are often applied in the clinical diagnosis and prognosis of early malignant tumors. Therefore, drugs targeting epigenetic changes are widely used in the clinical treatment of various malignant tumors, but there are still problems such as drug resistance, adverse reactions and low response rates, which greatly affect the quality of life and prognosis of patients. Traditional Chinese medicine has a unique clinical effect in the treatment of malignant tumors, and the anti-tumor mechanism of active ingredients of traditional Chinese medicine with multiple pathways, multiple molecules and multiple targets has become a research hotspot. Anti-tumor research is still rare, and anti-tumor traditional Chinese medicines based on epigenetic changes or drugs combined with epigenetic changes have important clinical value for some malignant tumors. This paper discussed epigenetic changes and related drugs, anti-tumor based on epigenetic changes, and active components of traditional Chinese medicine by regulating DNA methylation (DNMT), histone modification, ncRNA, chromatin structure remodeling, and targeted antitumor, etc, in order to provide ideas for the research and development of new traditional Chinese medicine drugs targeting anti-tumor from the perspective of epigenetic changes.