Post-stroke cognitive impairment (PSCI) is one of the common and severe complications in stroke patients, encompassing a spectrum of syndromes ranging from mild cognitive impairment to post-stroke dementia. Despite increasing research on PSCI in recent years, current treatment options remain limited. Modern medical research has revealed that the PI3K/AKT pathway is closely associated with apoptosis, neuroinflammation, synaptic plasticity, oxidative stress, and vascular regeneration, playing a crucial role in the pathophysiological process of PSCI. Traditional Chinese medicine (TCM) possesses advantages of multi-pathway, multi-functional, and multi-target effects. By regulating the PI3K/AKT pathway through various mechanisms, TCM has emerged as a potential new therapeutic approach for PSCI. This review summarizes the latest research progress on TCM"s [ ][ ]intervention in PSCI through regulating the PI3K/AKT signaling pathway. It systematically reviews the role of the PI3K/AKT signaling pathway in the pathogenesis of PSCI, as well as the mechanisms of action of TCM monomers, compound formulas, and proprietary Chinese medicines within this pathway. This review aims to provide a theoretical basis for future PSCI treatment and broaden the perspective for TCM applications in PSCI management.