Diabetic ulcers are one of the most serious complications of diabetes. Through searching literature on relevant clinical study and experimental research on accurate traditional Chinese medicine (TCM) syndrome differentiation and treatment of diabetic ulcer at home and abroad in recent years, this paper summed up research progress of precise syndrome differentiation of TCM internal treatment from precise syndrome differentiation, accurate treatment and objective basis of diabetic foot ulcers. The accurate treatment of TCM is the direction of TCM development in the future. TCM internal treatment of diabetic ulcer has significant advantages and curative effects, and its clinical and experimental study follows the TCM holistic concept and treatment based on syndrome differentiation, and contains and reflects the basic ideas of “precision medicine”, providing accurate basis for clinical therapies of TCM treatment of diabetic ulcer.