Cachexia is a syndrome of multifactorial metabolic disorders involving multiple organs and is a common fatal factor in patients with malignant tumors. The major clinical symptoms are muscle atrophy and loss, and their mechanism is associated with excessive protein degradation and synthesis disorders. In recent years, traditional Chinese medicine has made a significant advantage in the use of few side effects, multi-targets, and multi-channel intervention diseases. It has unique value in preventing and treating tumor disease and muscle atrophy. This review mainly discusses the effect of muscle protein degradation and synthesis mediated by various signals on tumor Cachexia muscle atrophy and the regulatory role of traditional Chinese medicine to provide a reference for the clinical application and research of traditional Chinese medicine in the treatment of tumor Cachexia muscle atrophy.