As one of the major lethal diseases in the world, the incidence rate and mortality of gastrointestinal tumors are increasing year by year, and the situation of prevention and control is grim. Although current Western medicine treatment can to some extent inhibit tumor proliferation and alleviate clinical symptoms, it still faces many challenges such as high risk of postoperative recurrence and metastasis, significant adverse drug reactions, and frequent drug resistance, resulting in unsatisfactory overall efficacy. Therefore, exploring new treatment strategies that are both efficient and safe has become an urgent clinical need. The Ras Homologg Family Member A (RhoA)/Rho associated coiled coil containing protein kinase (ROCK) signaling pathway plays a central regulatory role in the proliferation, differentiation, migration, and invasion of gastrointestinal tumor cells, and is deeply involved in the occurrence and development of tumors. It is considered an important target for anti gastrointestinal tumor therapy. Traditional Chinese medicine, with its synergistic effects of multiple pathways, mechanisms, and pathways, has demonstrated unique advantages in inhibiting tumor recurrence and metastasis after surgery, reducing adverse reactions to radiotherapy and chemotherapy, and improving patients" quality of life. It has become a key component of the comprehensive treatment system for gastrointestinal tumors. Research has shown that active ingredients in traditional Chinese medicine, such as terpenes, alkaloids, flavonoids, polyphenols, quinones, and indoles, as well as compound formulas such as Bufalin Capsules and Biejiajian Pills, can induce apoptosis of digestive tract tumor cells, inhibit epithelial mesenchymal transition, block vascular mimicry formation, reverse tumor drug resistance, enhance anti-tumor immune response, and block cell cycle by intervening in the RhoA/ROCK signaling pathway and its upstream and downstream networks, thereby exerting clear anti gastrointestinal tumor effects. This article comprehensively reviews and summarizes the relevant research results of traditional Chinese medicine in the treatment of digestive tract tumors in recent years, focusing on the mechanism of traditional Chinese medicine regulating the RhoA/ROCK signaling pathway for the treatment of digestive tract tumors, in order to provide reference and ideas for the development of new drugs for clinical anti digestive tract tumors.