Abstract: Chronic obstructive pulmonary disease（COPD） has been a disease with a high mortality rate in recent years, so the prevention and treatment of COPD is extremely important. One of the pathological characteristics of COPD is the high secretion of airway mucus, while mucin 5AC（MUC5AC）, as an important mucin in airway mucus, is inseparable from mucus secretion and a hub for the treatment of COPD. It has been found that flavonoids, phenols and other traditional Chinese medicine active ingredients and traditional Chinese medicine compounds have been proved to regulate the expression level of MUC5AC in many ways, and then play a role in improving COPD. In this review, we introduced in detail the main signaling pathways for the prevention and treatment of COPD by traditional Chinese medicine, aiming to show that traditional Chinese medicine and its active ingredients can regulate COPD by adjusting the expression of MUC5AC through different pathways, providing a new way for traditional Chinese medicine to prevent and treat COPD.