Osteosarcoma (OS) is a common primary malignant tumor of bone tissue, with high mortality, disability, metastasis and recurrence rates. Its pathogenesis is complex, which seriously affects the quality of life of patients and brings a huge economic burden to families and society. Traditional Chinese medicine has the characteristics of "multi-target, multi-component and multi-pathway". In recent years, a large number of animal or cell model experimental studies have found that The mechanism of OS progression is related to Notch, MAPK, Wnt / β-catenin, PI3K/Akt, Hedgehog and nuclear transcription Nf-κb, transforming growth factor-β (TGF-β)/Smad(Smad) and signal transducer and activator of transcription (STAT) pathways are closely related. Traditional Chinese medicine (TCM) can affect the biological processes such as cell proliferation, migration, invasion, apoptosis and autophagy by interfering with the above signaling pathways to play an anti-tumor role. Based on the cell signaling pathway, this study expounds the role of the above signaling pathways in OS, and summarizes the research status of traditional Chinese medicine intervention in the prevention and treatment of OS at home and abroad in recent years, aiming to provide a reference for further research on the treatment of OS with traditional Chinese medicine, in order to provide new ideas for clinical treatment of OS.