Abstract: Chronic rhinosinusitis (CRS) is a common chronic inflammation of nasal cavity and sinus mucosa, involving multiple pathogenesis mechanisms such as infection, allergic reactions, and immune abnormalities. Its main symptoms include nasal obstruction, rhinorrhea, and hyposmia, significantly affecting patients' quality of life. Seeking safe and effective long-term treatment methods is crucial for managing CRS. Traditional Chinese medicine (TCM) has a long history of treating CRS and has gained attention due to its profound theoretical basis, high safety, and low recurrence rate. According to TCM, CRS is mostly caused by the invasion of wind-cold-damp pathogens, heat accumulation in the Lung meridian, or spleen-stomach weakness. Various therapies such as oral administration of Chinese herbal medicines, nasal drops, acupuncture, and moxibustion are employed to adjust the body's balance and achieve therapeutic goals. This article comprehensively analyzed recent domestic and international literature and reviewed the research progress on pathogenesis of CRS and its treatment with TCM, with particular emphasis on roles and mechanisms of active ingredients in Chinese herbal medicines. The aim of the study is to provide scientific evidence and technical support for prevention and treatment of CRS.