Alzheimer’s disease (AD) is the most common neurodegenerative disorder worldwide, primarily characterized by cognitive impairment and memory dysfunction. Its pathological mechanisms include the toxic deposition of amyloid β-protein (Aβ), neurofibrillary tangles (NFTs) caused by excessive phosphorylation of Tau protein, mitochondrial dysfunction, synaptic impairment, cholinergic system dysfunction, neuroinflammation, and oxidative stress. Current clinical treatments for AD, such as acetylcholinesterase inhibitors and NMDA receptor antagonists, can provide some cognitive benefits but fail to slow disease progression and often cause side effects. Recent studies have shown that traditional Chinese medicine (TCM) can exert therapeutic effects on AD by regulating the phosphatidylinositol 3-kinase/protein kinase B (PI3K/AKT) signaling pathway. This review systematically summarizes research on how TCM, including active compounds, herbal extracts, and formulae, modulates the PI3K/AKT pathway in AD treatment. By integrating recent findings from both domestic and international studies, this paper aims to provide a theoretical foundation for the application of TCM in AD therapy.