Post-stroke cognitive impairment (PSCI) is the most common complication after stroke, characterized by memory loss, executive dysfunction and inattention as the main clinical manifestations. It seriously affects patients" quality of life and imposes a heavy burden on society and families. Neuroinflammation plays a crucial role in the occurrence and development of PSCI. NOD-like receptor protein 3 (NLRP3) inflammasome is a key molecular target for regulating neuroinflammation. It participates in the occurrence and progression of PSCI by mediating neuroinflammatory responses, disrupting the blood-brain barrier, inducing neuronal apoptosis, and impairing synaptic function. In recent years, numerous studies have confirmed that TCM therapies, such as single Chinese herbs and their active components, Chinese herbal compounds, and acupuncture and moxibustion, can inhibit neuroinflammation, protect neurological function, and improve cognitive levels in PSCI patients by regulating the NLRP3 inflammasome and its related signaling pathways. This paper systematically combs relevant literatures in the past 5 years, aiming to review the research progress of TCM in regulating the NLRP3 inflammasome for the treatment of PSCI, so as to provide a theoretical basis and practical reference for the prevention and treatment of PSCI with TCM.