The vast majority of patients with malignant tumors will consider TCM as one of the options to fight against cancer. However, there are great differences in the understanding of the exact effect and the pathway of onset of effect of TCM anti-cancer. At the same time, due to the prescription of TCM, each doctor’s prescription varies greatly, which also increases the difficulty of correctly understanding the anti-tumor effects of TCM. First of all, there are a large number of substances in Chinese medicine that have direct tumor-killing effects, which is clear from the published studies so far. Zanthoxanthin, huachanin, paclitaxel, hippuridine, arsenic trioxide are all extracted from plants or minerals, all of which have been used as Chinese medicine for a long time. These are the herbal extracts that have been marketed. And there are more ingredients reported in the literature that have shown anti-tumor effects on tumor cells or in animal experiments. For example, certain components in Shigella, Boswellia, Myrrh, Salvia, and Chrysanthemum have been reported to have antitumor effects. Therefore, from these studies mentioned above, it is clear that traditional Chinese medicine then has a direct killing effect on tumor cells. The view that TCM can only be used as post-operative tumor conditioning is not comprehensive. However, Chinese medicine has its own characteristics that are not only shown in the direct effect on tumor cells. It is the role of Chinese medicine in improving the immunity, regulating the body, improving the symptoms and improving the quality of life that the general public think. In addition, Chinese medicine has significant characteristics in this area, and it should be applied according to the different symptoms of Yang deficiency, Yin deficiency, Qi and blood deficiency, blood stasis and so on. At present, a lot of studies have shown that TCM can improve patients in many aspects, such as enhancing the function of immune cells. One is that there are few large-scale standardized clinical studies on certain tumors, unlike the internationally used chemotherapy regimens, which are often derived from large-scale clinical trials, but TCM is still based on the personal experience of Chinese doctors, emphasizing individualization, and there is no standard first-line or second-line regimen. This situation has both the advantage of being more individualized and the disadvantage of leading to inconsistency in the application, promotion and perception of TCM. The combination of the characteristics of TCM theory and the precision of modern medicine, the combination of individualization and standardization is the future direction of TCM anti-tumor.