Abstract: Fermented medicine is a kind of traditional Chinese medicine commonly used in clinical practice. However, the quality of fermented medicine is unstable, due to the inconsistency of raw materials and fermentation processing technology of fermented medicine used in different places, the large differences of natural bacterial species in various regions, and the complexity of the flora metabolism during the fermentation process. Therefore, the processing technology, processing mechanism and quality control methods of fermented medicine have been the hot in the research field of traditional Chinese medicine processing in recent years. With the application of multiple disciplines, such as processing chemistry, modern pharmacology and microbial genomics, the processing technology, processing mechanism and quality control methods of fermented medicine have achieved gratifying results. Fermentation processing technology has gradually changed from natural fermentation to pure strain co-fermentation and further clarifies the fermentation process parameters; the research on the processing mechanism has clarified the effective material basis and the changes of fermentation bacteria of some fermented medicines; and the use of thin layer chromatography, micro-differential method, HPLC, electronic tongue and nose also provide new methods for quality control.This paper aims to systematically summarize and analyze the research progress of the fermentation processing technology,processing mechanism and quality control methods of fermented medicine, so as to provide a reference for further exploration.