Alzheimer’s disease (AD) is the most common neurodegenerative disorder worldwide, characterized primarily by cognitive impairment and memory dysfunction. Its pathological mechanisms involve the toxic accumulation of amyloid β-protein (Aβ), hyperphosphorylation of Tau protein leading to neurofibrillary tangles, mitochondrial dysfunction, synaptic impairment, cholinergic system dysfunction, neuroinflammation, and oxidative stress. Current clinical treatments for AD include acetylcholinesterase inhibitors and N-methyl-D-aspartate antagonists, which can improve cognitive function but fail to slow disease progression and often have side effects. Research indicates that traditional Chinese medicine (TCM) may regulate the phosphatidylinositol 3-kinase/protein kinase B (PI3K/AKT) signaling pathway, promoting neuronal survival, inhibiting neuroinflammation, reducing oxidative stress, preventing apoptosis, and decreasing Aβ deposition, thus improving the symptoms of AD. This review summarizes the mechanisms by which individual TCM components, extracts, and formulas may regulate the PI3K/AKT pathway in the treatment of AD, with the aim of providing a theoretical foundation for the application of TCM in AD therapy.