Ischemic brain injury occurs when the metabolic needs of brain tissue cannot be met due to insufficient blood supply to the brain. It is one of the main causes of death and adult disability worldwide. The recurrence rate of ischemic brain injury is high. It places a heavy economic burden on families and society, and seriously affects human health and quality of life. In traditional Chinese medicine, ischemic stroke belongs to the category of“stroke”. The use of traditional Chinese medicine to treat stroke has a long history. After years of experimental research, a large amount of theoretical knowledge and practical experience have been accumulated. Promoting blood circulation and removing blood stasis is the basis of traditional Chinese medicine theory on the treatment of ischemic stroke. Commonly used single Chinese medicines include Chuangxiong (Ligusticum chuanxiong hort), Danggui (Angelica sinensis), Danshen (Salvia miltiorrhiza Bunge), Honghua (Carthamus tinctorius L.), Mudanpi (Moutan Cortex), and Huangqi (Astragali Radix). Buyang Huanwu decoction, Xinglou Chengqi decoction, Taohong Siwu decoction, and other traditional Chinese medicine prescriptions are believed to have a protective effect against brain damage caused by ischemic stroke. With the development of modern medical technology, the mechanism of traditional Chinese medicine treatments for ischemic brain injury has gradually been explored. This article reviews the mechanisms of traditional Chinese medicine\'s protection against ischemic brain injury and its current clinical application.