Vitiligo is a chronic and refractory pigmentary loss skin disease with a complex pathogenesis. Traditional Chinese medicine(TCM) offers advantages in treating vitiligo, such as multi-component and multi-target effects, delivering definite clinical efficacy. This article summarizes the action mechanisms of TCM monomer components and compound formulations in the treatment of vitiligo. It is found that pinostrobin, tribuloside and Erzhi pills can activate the cyclic adenosine monophosphate/protein kinase A (cAMP/PKA) signaling pathway; cannabidiol and tanshinone Ⅱ A can activate the p38 mitogen-activated protein kinase(p38 MAPK)signaling pathway; Ginkgo biloba extract EGb761 and astragaloside Ⅳ can activate the aryl hydrocarbon receptor(AhR) signaling pathway; escin and psoralen derivative BSP-1 can activate the Wnt/β-catenin signaling pathway; apigenin and Baiban granules can activate the nuclear factor erythroid 2-related factor 2/heme oxygenase-1(Nrf2/HO-1) signaling pathway; hyperoside and kaempferol can activate the phosphatidylinositol 3-kinase/protein kinase B(PI3K/Akt) signaling pathway; Ruyi heibai powder can activate the programmed death-1/programmed death-ligand 1(PD-1/PD-L1) signaling pathway; Compound honghua buji granules and demethylzeylasteral can inhibit the Janus kinase/signal transducer and activator of transcription (JAK/STAT) signaling pathway. These mechanisms promote melanin production and deposition, reduce oxidative stress, inhibit the destruction of melanocytes by autoimmunity, and reduce melanocyte apoptosis, thereby exerting therapeutic effects on vitiligo.