Abstract: Hepatic fibrosis is a pathological outcome of self-repair when various factors cause liver cell damage. Prolonged disease duration can further lead to liver cirrhosis, liver failure, and even liver cancer, seriously endangering human health and causing a heavy medical burden. The pathogenesis of hepatic fibrosis is complex and lacks effective drug treatments. Ferroptosis, as a novel form of regulated cell death, has mechanisms involving iron metabolism, lipid peroxidation, and antioxidant defense systems that are closely related to the occurrence and development of hepatic fibrosis. Current research indicates that active ingredients and compound prescriptions of traditional Chinese medicine can prevent and treat hepatic fibrosis by regulating ferroptosis of hepatic stellate cells or inhibiting ferroptosis of hepatocytes. This article systematically elaborates the regulatory pathways of ferroptosis, explores the relationship between ferroptosis and hepatic fibrosis, and summarizes the mechanisms of active ingredients and compound prescriptions of traditional Chinese medicine in preventing and treating hepatic fibrosis by regulating ferroptosis. It aims to provide ideas and references for the development of drugs for clinical treatment of hepatic fibrosis.