Edema is often the primary factor that leads patients to the nephrology department. Given that the causes of edema are numerous and span multiple specialties, and the prognosis and effects of TCM interventions are very different, it is important to form a rigorous diagnostic mind about edema. In general, when patients with edema are seen clinically, serious lesions of the heart, liver, kidneys and other important organs should be considered first. The first factor to consider nephrogenic edema is obvious facial swelling in the morning, and a preliminary judgment can be formed by combining abnormal renal function and urinary routine results, but it is still necessary to exclude edema of other organ causes. Cardiogenic edema is characterized by palpitations, shortness of breath, obvious aggravation after exertion, and sunken edema of the lower extremities, which is more obvious after afternoon, while edema caused by right heart failure has a history of chronic lung disease such as obstructive pulmonary disease. Hepatogenic edema is predominantly ascites and only develops systemically when it is extremely severe. It can be diagnosed mainly by combining the history of liver disease and morphological changes of the liver with the manifestation of portal hypertension. It is important to note that nephrogenic and cardiogenic edema to a severe degree will also accumulate fluid in the chest, abdominal cavity and pericardium, and one should not assume that ascites must be due to cirrhosis at the first sight. According to clinical experience, especially in recent years due to the improvement of people’s material and cultural level and increased concern for health, patients who visit the nephrology department with edema are in many cases not due to diseases of the heart, liver, kidney and other important organs after repeated examinations, and the degree of edema is also mild. In this case, it is necessary to consider hypothyroidism, idiopathic edema and other causes. Edema caused by abnormal thyroid function is usually called “emphysema” in Chinese medicine, i.e., it rises with the hand without forming a depression, and can be clearly diagnosed by examining the thyroid gland for significant and thyroid function measurement. After excluding the above factors, the most common type of oedema in female patients is idiopathic oedema, which can often be treated with good results through TCM evidence-based management, dredging the liver, relieving depression and moving qi, benefiting qi, activating blood and promoting water. The obvious edema of unilateral limbs, even with pain, is often an obvious clue to differentiate from generalized edema. Those with sudden local swelling and pronounced itching are mostly angioneurotic edema. In the case of superior vena cava syndrome, observation of marked dilatation of the cervicothoracic veins and varicose veins of the thoracoabdominal wall can provide diagnostic clues for further clarification by imaging.