Rheumatoid arthritis (RA) is an autoimmune disease with symmetric small joints pain as an early clinical manifestation, which gradually worsens and often involves multiple joints, ultimately resulting in arthritic deformities and loss of labor capacity. Molecular signaling pathways have always been the focus of research on the prevention and treatment of RA. Studies have found that the progression of RA disease is closely related to a variety of signaling pathways which include the Janus kinase-signal transducer and activator of transcription (JAK-STAT) signaling pathway, mitogen-activated protein kinases (MAPKs) signaling pathway, the NOD-like receptor protein 3 (NLRP3) signaling pathway, the toll-like receptors (TLRs) signaling pathway, the Wnt signaling pathway, Notch signaling pathway, hypoxia-inducible factor 1-alpha and vascular endothelial growth factor (HIF-1alpha/VEGF) signaling pathway, programmed death factor 1 and ligand 1 (PD-1/PD-L1) signaling pathway and phosphatidylinositol 3-kinase (PI3K)/protein kinase B (Akt)/mammalian target of rapamycin (mTOR) signaling pathway. In recent years, the studies on the treatment of RA with external treatment of traditional Chinese medicine based on the above signaling pathways have gradually increased and deepened. In this paper, we reviewed the relevant data and reports to explain the relationship between the above pathways and the pathogenesis and prevention of RA and summarized the research results on the modulation of the above signaling pathways by external treatment of traditional Chinese medicine to prevent and treat rheumatoid joints with a view to providing a scientific basis for the clinical selection of this treatment.