Abstract: Postoperative abdominal adhesion(PAA) is a common complication after abdominal surgery, mainly characterized by abnormal connections between the peritoneum, organs and the abdominal wall. Such abnormal connections may lead to chronic abdominal pain, constipation and diarrhea, intestinal obstruction, and even threaten the patient's life. Currently, the main surgical treatment method is adhesion lysis, which not only has a significant negative impact on the patient's quality of life, but also causes serious psychological stress. In recent years, traditional Chinese medicine(TCM) has been highly recognized by clinical workers and patients for its remarkable efficacy, low cost and few side effects. With the clinical application of the long-standing TCM theories of "syndrome differentiation and treatment" and "preventing disease before it occurs", more and more people have recognized the unique advantages of TCM in prevention. In recent years, the transforming growth factor-β1(TGF-β1)/Smads protein family has become an important target for the prevention and treatment of PAA due to its core role in inducing cell apoptosis, synthesizing and remodeling the extracellular matrix, immune regulation, tissue repair and angiogenesis. This article systematically reviews the mechanism of the TGF-β1/Smads signaling pathway in the prevention and treatment of PAA, and summarizes and generalizes from multiple aspects such as single extracts of traditional Chinese medicine, traditional Chinese medicine formulas and related preventive and therapeutic traditional Chinese medicines, aiming to provide a theoretical basis for the mechanism research and clinical intervention of PAA, and to offer systematic reference value for subsequent experimental research and clinical application around PAA.